Interventional management of chest wall sarcomatoid carcinoma mimicking breast cancer metastasis: A case report.

RATIONALE

Breast cancer patients have an increased risk of developing second primary malignancies, with lung cancer accounting for approximately 5% of cases. Differentiating between metastatic disease and a second primary malignancy remains a diagnostic challenge.

PATIENT CONCERNS

A 45-year-old woman with a history of triple-negative breast cancer presented with a newly detected chest wall nodule during routine follow-up.

DIAGNOSES

Contrast-enhanced imaging suggested metastatic disease. However, biopsy and immunohistochemistry confirmed a second primary lesion, consistent with either pulmonary sarcomatoid carcinoma or chest wall sarcoma.

INTERVENTIONS

The patient underwent a multimodal interventional regimen, including transarterial embolization followed immediately by radiofrequency ablation.

OUTCOMES

At 1 month post-treatment, follow-up imaging demonstrated significant tumor shrinkage with no evidence of local recurrence.

LESSONS

This case underscores the importance of comprehensive diagnostic evaluation to distinguish metastatic disease from second primary malignancies in breast cancer patients. It also highlights the potential of interventional therapy as a minimally invasive treatment option for inoperable tumors, with multidisciplinary management being essential to optimize outcomes and prognosis.