Sheen-Chen Shyr-Ming, Eng Hock-Liew, Ko Sheung-Fat
Department of Surgery, Chang Gung Memorial Hospital, Taiwan.
Anticancer Res. 2005 Jan-Feb;25(1B):527-9.
Secondary malignancy metastatic to the breast is uncommon, with an incidence of 0.5% to 3% of patients with extramammary malignancy. Although rhabdomyosarcoma is a common aggressive primary malignancy in the pediatric age group, metastatic deposits to the breast rarely occur and are mainly seen in adolescent girls. Here, we report an intriguing, rare adult case with metastasis to the breast from nasal rhabdomyosarcoma. A 31-year-old woman with the complaint of right neck mass noted recently came to this hospital for help. She had a history of nasal malignancy treated with radiotherapy in another hospital three months previously. Physical examination revealed multiple neck masses at bilateral neck areas. Bilateral neck dissection was performed and rhabdomyosarcoma, metastatic to lymph node, was the final diagnosis. One year after operation, the patient felt a large lump in her left breast. Surgical excision was performed and histological analysis was consistent with rhabdomyoblastic origin. Secondary malignancy metastatic to the breast is uncommon, yet this entity does exist. In view of the therapeutic implication, a metastatic breast lesion should not be mistaken as the primary breast carcinoma. Only with the awareness of such a possibility can prompt diagnosis and optimal treatment be achieved.
乳腺继发性恶性肿瘤转移并不常见,在乳腺外恶性肿瘤患者中的发生率为0.5%至3%。横纹肌肉瘤是儿童年龄组中常见的侵袭性原发性恶性肿瘤,乳腺转移灶很少见,主要见于青春期女孩。在此,我们报告一例罕见且有趣的成人病例,为鼻腔横纹肌肉瘤转移至乳腺。一名31岁女性因近期发现右颈部肿块前来我院求助。她三个月前在另一家医院接受过鼻腔恶性肿瘤放疗。体格检查发现双侧颈部区域有多个肿块。进行了双侧颈部清扫术,最终诊断为横纹肌肉瘤转移至淋巴结。术后一年,患者感觉左乳有一个大肿块。进行了手术切除,组织学分析与横纹肌母细胞起源一致。乳腺继发性恶性肿瘤转移并不常见,但确实存在。鉴于其治疗意义,转移性乳腺病变不应被误诊为原发性乳腺癌。只有意识到这种可能性,才能实现及时诊断和最佳治疗。