Hepatic metastasis from ductal breast carcinoma
70 year old female presents with crampy abdominal pain. Background of grade III, intraductal carcinoma of the breast treated by wide local excision 1 year ago.
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There is a heterogenous predominantly hypodense lesion in the right lobe of liver measuring approximately 7.8 x 6.9 x 7.3 cm. The lesion is centered in segment 8 and 7 and there is approximately 6 mm clearance from the middle hepatic vein on CT imaging.
No other liver lesions are identified. There is no intra or extrahepatic biliary duct dilatation.
The patient underwent an R) portal vein embolization and subsequently an extended R) hepatectomy.
The large tan, nodular lesion measured 95x90x80mm with a large area of central necrosis.
The immunohistological showed positive staining for CEA, CK7 and GATA3. Negative staining for CK20, ER, PR and Hep Par1. This staining pattern was similar to the breast carcinoma obtained from a wide local excision 1 year ago.
This confirmed the diagnosis of metastatic breast ductal carcinoma.