LATE LIVER METASTASIS 20 YEARS AFTER THE INITIAL DIAGNOSIS: A CASE REPORT OF METACHRONOUS HORMONE DEPENDENT TUMORS OF BREAST AND ENDOMETRIUM

Ivan Ilić, Maja Jovičić Milentijević, Aleksandar Milićević, Milica Stanković, Aleksandra Radičević

DOI Number
http://doi.org/10.22190/FUMB201110009I
First page
56
Last page
60

Abstract


Breast cancer is the most common cancer and a significant cause of morbidity and mortality in female population worldwide. The liver is the third most common metastatic site for invasive breast malignancy besides bones, lungs and brain. Breast cancer has been linked with metachronous bone, endometrial, colon/rectal, connective tissue (sarcoma), leukemia, lung, ovary or thyroid cancer. Studies have shown an increased risk of secondary malignancies in women treated for breast malignancy in connection to adjuvant treatment in certain cases.

We present a case of a 71 year old woman who was diagnosed with breast cancer 20 years ago. The primary diagnosis was invasive lobular breast cancer localized in left lower lateral quadrant. Micromorphological, histochemical and immunohistochemical analyses rendered diagnosis inconclusive due to lack of tissue so after 4 months rebiopsy was performed. Clinico-pathological correlation of the second biopsy was in favor of liver metastasis of partially hormone dependent breast cancer. Immunohistochemistry was vital for the diagnosis on the liver biopsy, in particular GATA3 positivity and vimentin negative staining which helped us exclude endometrial cancer metastasis which was diagnosed before the initial liver biopsy. GATA 3(+)/vimentin(-) panel proved to be superior to GCDFP-15 and mammaglobin in proving the breast origin of  the secondary tumor deposit.

Liver metastasis from primary breast cancer can in certain cases occur many years after the initial diagnosis which shows the importance and necessity for long term follow-up of these patients, while considering the possibility of metachronous tumors as well.


Keywords

breast cancer, liver metastases, immunohistochemistry, metachronous tumors

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References


Yazdani A. Risk factor of liver metastases in breast cancer. Arch Cancer Sci Ther 2019; 3:63–65.

Hess KR, Varadhachary GR, Taylor SH, Wei W, Raber MN, Lenzi R, et al. Metastatic patterns in adenocarcinoma. Cancer 2006; 106:1624–1633.

Koo JS, Jung W, Jeong J. Metastatic breast cancer shows different immunohistochemical phenotype according to metastatic site. Tumori 2010; 96: 424–432.

Sangoi AR, Shrestha B, Yang G, Mego O, Beck AH. The novel marker GATA3 is significantly more sensitive than traditional markers mammaglobin and GCDFP15 for identifying breast cancer in surgical and cytology specimens of metastatic and matched primary tumors. Appl Immunohistochem Mol Morphol 2016; 24:229–237.

Takeshita T, Yan Li, Asaoka M, Rashid O, Takabe K. Late recurrence of breast cancer is associated with pro-cancerous immune microenviroment in the primary tumor. Sci Rep 2019; 15:16942.

De Lara S, Parris TZ, Ronnerman EW, Helou K, Kovacs A. GATA3 as a putative marker of breast cancer metastasis – a retrospective immunohistochemical study. Breast J 2018; 24:

–188.

Schenker JG, Levinsky R, Ohel G. Multiple primary malignant neoplasms in breast cancer patients in Israel. Cancer 1984; 54:145–150.

Kirova YM, Rycke De, Gambotti L, Pierga JY, Asselain B, Fourquet A. Second malignancies after breast cancer: the impact of different treatment modalities. Br J Cancer 2008; 98:870–874.

Mellemkjaer L, Friis S, Olsen JH, Scelo G, Hemminki K, Tracey E, et al. Risk of second cancer among women with breast cancer. Int J Cancer 2006; 118:2285–2292.

Kim JY, Song HS. Metachronous double primary cancer after treatment of breast cancer. Cancer Res Treat 2015; 47:64–71.

Park JH, Kim JH. Pathologic differential diagnosis of metastatic carcinoma in the liver. Clin Mol Hepatol 2019; 25:12–20.




DOI: https://doi.org/10.22190/FUMB201110009I

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ISSN 0354-2017 (Print)

ISSN 2406-0526  (Online)