Solitary Pancreatic Head Metastasis from Ductal Carcinoma of Breast: A Case Report

Overview

Journal Indian J Surg Oncol

Specialty Oncology

Date 2021 May 17

PMID 33994746

Citations 1

Authors

Parag Ingle

Pravin Khandare

Manjit Rajput

Megha Tiwari

Mangesh Patil

Ajay Mehta

Affiliations

Soon will be listed here.

Abstract

Liver, bones, and brain are common sites for breast cancer metastasis. We report here a rare scenario of metastasis to pancreatic head from breast cancer after a disease free interval of 7 years. A 60-year old breast cancer survivor noticed upper abdominal pain for 2 weeks, and her investigations revealed a pancreatic head mass lesion. Computed tomography imaging revealed a solitary pancreatic mass lesion with portal cavernoma formation and a guided biopsy yielded adenocarcinoma on histopathological examination. Immunohistochemistry processing demonstrated estrogen receptor, cytokeratin 7, and GATA 3 positivity which confirmed it to be a metastasis. Therapy was initiated with palbociclib and exemestane. Later, everolimus was started in view of failure of hormonal therapy. The patient is still alive 21 months after diagnosing the recurrence.

Citing Articles

Fine needle aspiration of pancreatic lesions focusing on secondary tumors with emphasis of metastatic breast cancer: A clinicopathological study with follow-up.

Chen M, Zarrin-Khameh N, Xu Y Cancer Med. 2022; 12(5):5485-5493.

PMID: 36281523 PMC: 10028048. DOI: 10.1002/cam4.5374.

References

Apodaca-Rueda M, Chaim F, Garcia M, Saito H, Gestic M, Utrini M . Solitary pancreatic metastasis from breast cancer: case report and review of literature. Sao Paulo Med J. 2017; 137(2):201-205. PMC: 9721236. DOI: 10.1590/1516-3180.2017.0144260617. View

Crippa S, Angelini C, Mussi C, Bonardi C, Romano F, Sartori P . Surgical treatment of metastatic tumors to the pancreas: a single center experience and review of the literature. World J Surg. 2006; 30(8):1536-42. DOI: 10.1007/s00268-005-0464-4. View

Milano M, Zhang H, Metcalfe S, Muhs A, Okunieff P . Oligometastatic breast cancer treated with curative-intent stereotactic body radiation therapy. Breast Cancer Res Treat. 2008; 115(3):601-8. DOI: 10.1007/s10549-008-0157-4. View

Mehta S, Jagannath P, Krishnamurthy S, de Souza L . Isolated pancreatic metastasis from locally controlled breast cancer: a case report. Indian J Cancer. 1991; 28(1):48-50. View

Possanzini M, Greco C . Stereotactic radiotherapy in metastatic breast cancer. Breast. 2018; 41:57-66. DOI: 10.1016/j.breast.2018.06.011. View

Perez Ochoa A, Saez Hernaez F, Cajigas Fernandez C, Perez de la Lastra L, Ondiviela Gracia R, Garcia de Polavieja M . Pancreatic metastases from ductal and lobular carcinomas of the breast. Clin Transl Oncol. 2007; 9(9):603-5. DOI: 10.1007/s12094-007-0110-8. View

Finn R, Martin M, Rugo H, Jones S, Im S, Gelmon K . Palbociclib and Letrozole in Advanced Breast Cancer. N Engl J Med. 2016; 375(20):1925-1936. DOI: 10.1056/NEJMoa1607303. View

Turner N, Ro J, Andre F, Loi S, Verma S, Iwata H . Palbociclib in Hormone-Receptor-Positive Advanced Breast Cancer. N Engl J Med. 2015; 373(3):209-19. DOI: 10.1056/NEJMoa1505270. View

Baselga J, Campone M, Piccart M, Burris 3rd H, Rugo H, Sahmoud T . Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med. 2011; 366(6):520-9. PMC: 5705195. DOI: 10.1056/NEJMoa1109653. View

10.

Zaha D . Significance of immunohistochemistry in breast cancer. World J Clin Oncol. 2014; 5(3):382-92. PMC: 4127609. DOI: 10.5306/wjco.v5.i3.382. View

11.

Amore Bonapasta S, Gregori M, Lanza R, Sangiorgi E, Menghi A, Scarpini M . Metastasis to the Pancreas from Breast Cancer: Difficulties in Diagnosis and Controversies in Treatment. Breast Care (Basel). 2010; 5(3):170-173. PMC: 2931056. DOI: 10.1159/000314249. View

12.

Yoo G, Yu J, Park W, Huh S, Choi D . Prognostic factors in breast cancer with extracranial oligometastases and the appropriate role of radiation therapy. Radiat Oncol J. 2016; 33(4):301-9. PMC: 4707213. DOI: 10.3857/roj.2015.33.4.301. View

13.

Makhlin I, Fox K . Oligometastatic Breast Cancer: Is This a Curable Entity? A Contemporary Review of the Literature. Curr Oncol Rep. 2020; 22(2):15. PMC: 7219961. DOI: 10.1007/s11912-020-0867-2. View

14.

Nakamura E, Shimizu M, Itoh T, Manabe T . Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int. 2001; 51(9):686-90. DOI: 10.1046/j.1440-1827.2001.01258.x. View

15.

Tseng H, Chen C, Chan W, Chiang J . Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles. World J Gastroenterol. 2009; 15(47):5972-5. PMC: 2795185. DOI: 10.3748/wjg.15.5972. View

16.

Kobayashi T, Ichiba T, Sakuyama T, Arakawa Y, Nagasaki E, Aiba K . Possible clinical cure of metastatic breast cancer: lessons from our 30-year experience with oligometastatic breast cancer patients and literature review. Breast Cancer. 2012; 19(3):218-37. DOI: 10.1007/s12282-012-0347-0. View

17.

Hanahan D, Weinberg R . The hallmarks of cancer. Cell. 2000; 100(1):57-70. DOI: 10.1016/s0092-8674(00)81683-9. View

18.

Lee Y . Breast carcinoma: pattern of metastasis at autopsy. J Surg Oncol. 1983; 23(3):175-80. DOI: 10.1002/jso.2930230311. View

19.

Rastogi S, Gulia S, Bajpai J, Ghosh J, Gupta S . Oligometastatic breast cancer: A mini review. Indian J Med Paediatr Oncol. 2014; 35(3):203-6. PMC: 4202615. DOI: 10.4103/0971-5851.142035. View

20.

Nieto Y, Nawaz S, Jones R, Shpall E, Cagnoni P, McSweeney P . Prognostic model for relapse after high-dose chemotherapy with autologous stem-cell transplantation for stage IV oligometastatic breast cancer. J Clin Oncol. 2002; 20(3):707-18. DOI: 10.1200/JCO.2002.20.3.707. View