Cases reported "Carcinoma, Lobular"

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1/5. Metastatic lobular breast carcinoma to an endometrial polyp diagnosed by hysteroscopic biopsy.

    BACKGROUND: Secondary tumors involving the uterus are rare, and most come from the close vicinity. Among non-gynecologic origins, breast tumors are the most frequent, being predominantly of the lobular carcinoma type. CASE: A 69-year-old woman presented with metrorrhagia. The patient had been diagnosed 4 years before with infiltrating lobular breast carcinoma. Follow-up was uneventful. She underwent hysteroscopy with biopsy. An endometrial polyp was seen. Microscopically, small malignant cells diffusely infiltrated the endometrial stroma and surrounded the atrophic endometrial glands. Immunohistochemical studies confirmed the diagnosis of metastatic lobular breast carcinoma. CONCLUSION: Although rare, breast tumors can metastasize to an endometrial polyp, even in the absence of other disseminations. Abnormal vaginal bleeding in a patient with known breast carcinoma can be the first sign of metastasis.
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ranking = 1
keywords = gynecologic
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2/5. breast cancer metastatic to the vulva.

    BACKGROUND: Primary cancer of the vulva is not common, constituting only 3-5% of all gynecologic malignancies and <1% of all cancer in the female. Metastatic tumors of the vulva are even more unusual, constituting only 5-8% of all vulvar cancers. CASE: A 32-year-old female underwent total mastectomy with axillary lymph node dissection for left breast cancer. The patient was well with a postoperative follow-up period of 40 months till a 1.2-cm lump was noted in her left labium majus. Excisional biopsy was performed and histologic examination was done. Pathologic examination of the breast cancer revealed coexistence of intraductal carcinoma and invasive lobular carcinoma. The histologic feature of the invasive lobular carcinoma was consistent with that of the vulvar lesion. The vulvar cancer was consistent with a metastatic lobular carcinoma from the breast. CONCLUSION: Only with careful gynecologic surveillance in women with breast cancer can the unusual sites of metastasis be detected earlier and appropriately treated.
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ranking = 2
keywords = gynecologic
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3/5. Unexpected metastatic lobular carcinoma of the breast with intraabdominal spread and subsequent port-site metastasis after diagnostic laparoscopy for exclusion of ovarian cancer.

    INTRODUCTION: Although lobular carcinomas metastasize primarily to lymph nodes, bone, lung and liver, they can also spread to the gastrointestinal tract, peritoneum and gynecologic organs. CASE REPORT: We report a case of intraperitoneal carcinomatosis of a lobular breast carcinoma that metastasized primarily to the peritoneum, with a subsequent abdominal wall invasion at the trocar site following laparoscopic surgery for the exclusion of an ovarian carcinoma. DISCUSSION: Port-site metastases (PSM) have occurred after laparoscopic surgery for endometrial, fallopian tube, ovarian, and cervical cancers. This is the first report of PSM of a lobular breast carcinoma primarily metastasized to the abdominal cavity. Every surgeon should be aware of the metastatic pattern of breast cancer, especially in relation to its histological subtypes. This case report emphasizes that PSM can occur in various kinds of gynecologic tumors, including breast cancer.
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ranking = 2
keywords = gynecologic
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4/5. Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases.

    tamoxifen (TAM) is widely used in the treatment of breast cancer, and its paradoxical effects on female genital system are well known. During the past 10 years, many descriptions of nonepithelial uterine malignancies related to long-term TAM usage have been reported in the literature. Four uterine sarcoma patients who had history of TAM usage for previous breast cancer are presented in this study. The mean time of exposure to TAM was 6 (range 3-11) years, and the mean cumulative dose of drug was 43.82 g. All patients were postmenopausal, and the mean age was 66 (range 61-73) years at the time of the diagnosis of the uterine malignancy. Two (50%) patients had uterine malignant mixed mullerian tumor, and two (50%) had leiomyosarcoma. In one (25%) patient was diagnosed with endometrial biopsy made for a postmenopausal vaginal bleeding; the others (75%) were asymptomatic and their diseases were diagnosed during the pelvic examination and transvaginal ultrasonography. All patients underwent surgery /- adjuvant therapy (chemotherapy and/or radiation therapy), and two (50%) patients died because of the sarcoma. In consequence, early detection of TAM-related uterine sarcoma is required for orderly gynecological examination in patients having history of TAM usage for previous breast cancer.
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ranking = 1
keywords = gynecologic
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5/5. Lobular breast carcinoma metastatic to the vulva: a case report and literature review.

    BACKGROUND: Six previous reports have documented a vulvar metastasis from breast cancer; one has noted involvement of the Bartholin's gland. CASE: A 53-year-old woman presented with an enlarging vulvar mass. Evaluation also identified a breast lesion. Surgical excision confirmed an invasive lobular breast carcinoma with a distant metastatic focus on the vulva. CONCLUSION: This is the first report in the English literature to document a vulvar metastasis from an invasive lobular carcinoma and the second to identify involvement of the Bartholin's gland. Careful gynecologic surveillance is needed in women with breast cancer.
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ranking = 1
keywords = gynecologic
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