Soni Sanjay Vikram, Malhotra Vikas, Sharma Raman, Singh Meeta, Dixit Rashmi, Mallya Varuna
Otolaryngology - Head and Neck Surgery, Maulana Azad Medical College, New Delhi, IND.
Cureus. 2022 Jul 31;14(7):e27497. doi: 10.7759/cureus.27497. eCollection 2022 Jul.
Nasopharyngeal carcinoma is a prevalent head and neck cancer, especially in Southeast Asia. Although its potential for distant metastasis is well established, metastasis to the breast has seldom been reported. To the best of our knowledge, this is the fourth report of a case of nasopharyngeal carcinoma metastasizing to bilateral breasts. A 35-year-old patient presented with left nasal obstruction, epistaxis, and a palpable mass in her left breast, without any cervical or axillary lymph nodal enlargement. Radiological examination with contrast-enhanced computed tomography scan and magnetic resonance and imaging of breast revealed the presence of enhancing mass lesions in bilateral breasts. Histopathology of the nasal mass was suggestive of undifferentiated nasopharyngeal carcinoma. Breast fine needle aspiration revealed an abundance of metastatic squamous cells. Immunohistochemistry examination was positive for chromogranin A, synaptophysin, and cluster of differentiation-56, confirming the diagnosis of a primary nasopharyngeal malignancy metastasizing to bilateral breasts. Differentiation between metastatic disease and a coexisting second primary is imperative for planning appropriate treatment and defining the further outcomes.
鼻咽癌是一种常见的头颈癌，在东南亚地区尤为常见。尽管其远处转移的可能性已得到充分证实，但转移至乳腺的情况鲜有报道。据我们所知，这是第四例鼻咽癌转移至双侧乳腺的病例报告。一名35岁患者出现左侧鼻塞、鼻出血，左侧乳腺可触及肿块，无任何颈部或腋窝淋巴结肿大。通过增强计算机断层扫描、磁共振成像及乳腺成像进行的影像学检查显示双侧乳腺存在强化的肿块病变。鼻腔肿块的组织病理学提示为未分化鼻咽癌。乳腺细针穿刺显示大量转移性鳞状细胞。免疫组织化学检查嗜铬粒蛋白A、突触素和分化簇56呈阳性，证实为原发性鼻咽恶性肿瘤转移至双侧乳腺。区分转移性疾病和并存的第二原发性肿瘤对于规划适当的治疗方案及确定进一步的预后至关重要。
