Gynecologic Oncology Case Reports - Metastatic ovarian papillary serous carcinoma to the breast: Diagnosis and pitfalls

ScienceDirect.com - Gynecologic Oncology Case Reports - Metastatic ovarian papillary serous carcinoma to the breast: Diagnosis and pitfalls

Highlights

► The breast as a site of metastasis from primary ovarian carcinoma is uncommon.
► Distinguishing these metastases from primary breast tumors is important because the prognosis and therapeutic approach differ significantly.
► Immunohistochemical markers (e.g., PAX8) can be utilized when morphology and clinical history are insufficient to render the correct diagnosis.

Introduction

Breast metastases from ovarian carcinoma (OC) have scarcely been reported. Morphologic and radiographic similarities between primary breast cancers (BC), and high grade papillary serous (PS) OC make distinguishing between the two diagnoses challenging, yet carry important consequences for treatment and prognosis. Herein, we describe a patient with a metastatic OC presenting with a palpable breast mass and discuss the utility of immunohistochemistry for distinguishing between OC and BC.

Case

A 52-year-old woman with no familial cancer history and an unknown BRCA-status presented with a palpable right breast mass. Four years earlier, she had been diagnosed with and treated for advanced stage high grade PS OC with neoadjuvant carboplatin–paclitaxel followed by an optimal interval cytoreductive surgery and additional chemotherapy. Her serum cancer antigen-125 (CA-125) normalized after treatment, and she had no evidence of disease. At the time of her first recurrence, 16-months later, her serum CA125 was 453U/mL and a biopsy of a xyphoid mass revealed recurrent high grade PS OC