6533b7d6fe1ef96bd12667d1

RESEARCH PRODUCT

Metastatic seeding of colon adenocarcinoma manifesting as synchronous breast and chest wall localization: report of a case.

Calogero CipollaMaria Rosaria ValerioDaniela CabibiSabrina Ingrao

subject

Pathologymedicine.medical_specialtyColorectal cancerReceptor ErbB-2Estrogen receptorNeoplasm SeedingBreast NeoplasmsIntercostal MusclesSettore MED/08 - Anatomia PatologicaAdenocarcinomaBone and BonesMetastasisCytokeratinNeoplasm SeedingMetaplasiamedicineCarcinomaHumansAgedMetaplasiabusiness.industryGeneral MedicineThoracic Neoplasmsmedicine.diseasedigestive system diseasesSettore MED/18 - Chirurgia GeneraleMetastatic seeding colon adenocarcinoma breast cdx2ck20 ck7Receptors EstrogenColonic NeoplasmsSurgeryFemaleDifferential diagnosismedicine.symptombusinessReceptors Progesterone

description

Colon carcinoma rarely metastasizes to the breast and it is usually associated with a poor prognosis. Even rarer is metastatic seeding of colon cancer cells in an intramammary location after surgery. Including a primary breast malignancy in the differential diagnosis of such cases is mandatory. We report a rare case of double seeding implantation of colon adenocarcinoma inside the breast parenchyma and intercostal muscles 6 years after resection of a pulmonary metastasis from colon adenocarcinoma. The metastasis was revealed by the presence of bone metaplasia in the intercostal muscles. We discuss how negative immunostaining for estrogen receptors, progesterone receptors, and HER-2, along with the immunohistochemical pattern of cytokeratin (CK) 20+/7-/5- and CDX2-positive immunostaining, excludes a primary breast malignancy, namely, a "matrix-producing" carcinoma, from the differential diagnosis. We also present the hypothesis of a paracrine pathogenetic mechanism to explain the bone metaplasia.

yearjournalcountryeditionlanguage
2011-02-01Surgery today
10.1007/s00595-009-4222-3https://pubmed.ncbi.nlm.nih.gov/21264761