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Barrios M, Perez NE, Briski LM, Pluguez-Turull C. Recurrent ectopic primary breast adenocarcinoma of the vulva with a 19-year follow-up period. BMJ Case Rep 2024; 17:e257791. [PMID: 38367988 PMCID: PMC10875544 DOI: 10.1136/bcr-2023-257791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Abstract
We present a case of an ectopic breast adenocarcinoma of the vulva with metastatic local recurrence and a total follow-up period of 19 years, the longest documented in the literature to our knowledge. Following surgical excision, radiation therapy and hormonal treatment after the recurrence, the patient has remained disease free. This case demonstrates the potential for malignant transformation in accessory breast tissue and highlights the importance of close surveillance and regular physical examinations in patients with a history of ectopic breast malignancy.
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Affiliation(s)
- Mirelys Barrios
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nathalie E Perez
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Laurence M Briski
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Cedric Pluguez-Turull
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Cicek SK, Simsek B, Gundogdu C. Right Common Femoral Vein Invasion: A Unique Case of Inguinal Ectopic Breast Cancer. Vasc Endovascular Surg 2023; 57:914-918. [PMID: 37300453 DOI: 10.1177/15385744231183489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Ectopic breast cancer may present anywhere in the milk line, from the axilla to the groin which is extremely rare in the inguinal region. Despite morphologic differences, ectopic breast tissue presents characteristics related to orthotopic breast tissue in terms of function and pathologic degeneration. The case report describes the treatment of a unique ectopic breast carcinoma which was located in the inguinal region with a common femoral vein invasion. METHODS We present a unique case of an ectopic breast carcinoma presenting in an unusual anatomic location along the milk line. The study was approved by the local Ethics Committee (protocol no: 12.01.2023-2023/02) Informed consent was obtained from the patient. RESULTS The patient is surgically treated and supplemented with neoadjuvant chemotherapy,radiotherapy and endocrine therapy. Histopathological examination revealed the diagnosis of invasive ductal carcinoma. The right common femoral vein was reconstructed with bovine pericardial patch after totally removal of the mass. CONCLUSIONS This report alerts the reader to be cognizant of the unusual location of an ectopic breast cancer which was detected in the inguinal region with a common femoral vein invasion and discusses the treatment, suggesting novel therapeutic advice that could bring considerable clinical advantages. A multidisciplinary approach should be warranted in such cases to confirm a complete remission.
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Affiliation(s)
- Sevim Kuslu Cicek
- Department of General Surgery, Medicana International Hospital, Istanbul, Turkey
| | - Baran Simsek
- Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey
| | - Cemal Gundogdu
- Department of Pathology, Medicana International Hospital, Istanbul, Turkey
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Mansour M, Zahra O, Nabulsi D, Alhamwi A, Chahin M, alani WR, Yousef D, Kanbour I, Kurdi B, Mohammad Deeb A. Ectopic primary ductal breast carcinoma of the vulva: a case report and literature review. Ann Med Surg (Lond) 2023; 85:5138-5144. [PMID: 37811111 PMCID: PMC10553189 DOI: 10.1097/ms9.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/02/2023] [Indexed: 10/10/2023] Open
Abstract
Background Ectopic breast tissue (EBT) is normally found along the rudimentary mammary line, which is located from the axilla to the inguinal region and disappears during embryogenesis. Up to 6% of females around the world suffer from EBT. EBT cancer is rare, with only a few reports in the literature. The diagnosis, and treatment of these rare cases can be very difficult and complex. Case presentation The authors report an interesting case of a 74-year-old female patient with a vulvar lump located on the mons pubis associated with ulceration, pain, and size increase. The histopathological study demonstrated an invasive ductal carcinoma grade 2 arising from EBT in the vulva. Within 4 months of follow-up, the patient's condition was stable. Clinical discussion and conclusions Throughout this paper, the authors aim to highlight the diagnostic and therapeutic challenges since there are no current guidelines for treatment for such cases. Furthermore, this article describes this rare disease and includes surgical details, difficulties, diagnostic methods, and treatment options.
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Affiliation(s)
- Marah Mansour
- Department of Colorectal Surgery, Mayo Clinic, Rochester, MN
- Faculty of Medicine, Tartous University, Tartous
| | - Orgwan Zahra
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Dalia Nabulsi
- Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | | | | | | | - Diaa Yousef
- Faculty of Medicine, Aleppo University, Aleppo
| | - Ilda Kanbour
- Department of Gynecology, Obstetrics University Hospital, Damascus
| | - Bashar Kurdi
- Department of Gynecology, Obstetrics University Hospital, Damascus
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Achouri L, Jellali A, Henchiri H, Boukhris S, Zaaimi Y, Mansouri H, Mahjoub N. Primary ectopic breast carcinoma: a case report. J Med Case Rep 2022; 16:443. [PMID: 36434655 PMCID: PMC9700870 DOI: 10.1186/s13256-022-03670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Ectopic breast tissue is present in 2-6% of women. Ectopic mammary tissue can experience physiological changes and the same pathological processes as the eutopic breast. Ectopic breast cancer represents an uncommon condition accounting for 0.3% of all breast neoplasms, and it is most frequently located in the axilla. CASE REPORT We report a rare case of a 57-year-old Tunisian woman who presented with a left-sided axillary mass evolving for about 1 month. The axillary ectopic breast tissue containing the mass was excised with axillary dissection. Pathology revealed a medullary multifocal carcinoma and metastasis was detected in two lymph nodes. She had local radiotherapy after six cycles of chemotherapy. She received herceptin therapy and hormonotherapy. After a 2-year follow-up, no evidence of local recurrence or distant metastases have been identified. CONCLUSION Ectopic breast carcinoma is a rare entity that should be the first diagnosis to be considered if an axillary lump is present in ectopic breast tissue. No particular guidelines on diagnosis and treatment are available. Therefore, physicians should be aware of this condition to avoid treatment delays. Once diagnosed, careful patient follow-up is essential because of the ambiguous natural history of this rare entity.
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Affiliation(s)
- Leila Achouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Amani Jellali
- Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia ,Department of Surgical Oncology, Salah Azaïz Institute of Cancer, Tunis, Tunisia
| | - Houda Henchiri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia
| | - Sabrine Boukhris
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Yosra Zaaimi
- Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia ,Department of Gastroenterology, Charles Nicole Hospital, Tunis, Tunisia
| | - Houyem Mansouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Najet Mahjoub
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
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Busbait S, Alkhalifa AM, Aljohani S, Alhaddad H. Occult Invasive Lobular Carcinoma Presenting as an Axillary Skin Metastatic Lesion Underwent Neoadjuvant Endocrine Therapy and Surgical Resection: A Case Report and Review of Literature. BREAST CANCER: TARGETS AND THERAPY 2022; 14:145-152. [PMID: 35669610 PMCID: PMC9166690 DOI: 10.2147/bctt.s366785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/23/2022] [Indexed: 11/23/2022]
Abstract
Introduction Invasive lobular carcinoma (ILC) is the second most common type of breast cancer accounting for 5–15% of all breast cancer cases. It usually presents with nonspecific signs and symptoms. Occult breast cancer presenting as an axillary mass is rare, with prevalence of 0.3–1%, less likely with isolated cutaneous breast metastasis as a first presentation. There are limited data in the literature on patients who underwent endocrine therapy and complete surgical resection. Case Presentation A 54-year-old woman with left axillary skin swelling that had been persisting for 6 years was diagnosed with ILC 18 months ago presenting with an ulcerated axillary skin lesion and was managed with letrozole in another facility as she was estrogen receptor (ER) and progesterone receptor (PR) positive. She received letrozole for 18 months and had a partial response in the form of healing of the ulcer with persistent subcutaneous nodules. Her breast mammogram, ultrasound, and magnetic resonance imaging findings were unremarkable; however, there were few prominent left axillary lymph nodes. A biopsy of the left axillary lymph node was positive for malignancy, consistent with ILC. A skin punch biopsy of the axillary skin lesion showed ILC extending to the dermis with no background breast tissue. The patient underwent left modified radical mastectomy with excision of the left axillary skin lesion. The breast specimen comprised 0.4 mm of ILC as the primary malignancy and nine positive axillary lymph node malignancies. The patient received adjuvant radiotherapy and continued to receive letrozole. There were no signs of complications or recurrence during the follow-up period. Conclusion Ulcerated skin lesions in the axilla should raise concerns regarding breast cancer metastasis. In cases of isolated cutaneous breast metastases, surgical excision can be considered in combination with endocrine therapy.
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Affiliation(s)
- Saleh Busbait
- Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
- Correspondence: Saleh Busbait, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Al-Khobar, 31441, Saudi Arabia, Tel +966 138966666 Ext 1680, Fax +966 133330108, Email
| | - Abdullah M Alkhalifa
- Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Shahad Aljohani
- Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Hiyam Alhaddad
- Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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