Renal cell carcinoma metastasis to breast

Case contributed by Dr Henry Knipe

Presentation

History withheld.

Patient Data

Age: 65 years
Gender: Female

Multiple pulmonary metastases are demonstrated. Hyperdense lesions are seen in the right breast, right paraspinal muscles, and left lattissimus dorsi musle.

No mediastinal, hilar or axillary lymphadenopathy. No pleural or pericardial effusion.

Indeterminate ill-defined density in the upper inner quadrant of the right breast.

Hypoechoic mass lesion at 1 o'clock 4 cm FN, which corresponds with the density seen on mammogram. 

The patient proceeded to ultrasound-guided core biopsy of this mass.

MICROSCOPIC DESCRIPTION: Sections of breast core biopsies show features of metastatic renal cell carcinoma of clear cell type. The tumor is comprised of nests surrounded by delicate vascular stroma.

DIAGNOSIS: Right breast 1 o'clock 4 cm biopsy: Metastatic carcinoma features in keeping with a renal primary. SUPPLEMENTRAY REPORT Immunohistochemistry on core biopsy shows tumor cells stain positive with CD10 and negative with ER. Features support the diagnosis of metastatic renal cell carcinoma.

Case Discussion

Metastases to the breast are uncommon causes and account for ~1% of all breast malignancies. The most frequent source is a contralateral breast cancer but there are a number of extramammary malignancies that can metastasize to the breast. 

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