case repot presents a unique case of adenocaecinoma of the pancreas with distant metastasis to the breast mimicking an Invasive ductal carcinoma of the breast in a patient after lumpectomy due to previous breast cancer.
Material and Methods: We use the littrature to futher investigate and confirm this unusual metastatic spread
Results: -case
73 years old woman with a history of right sided lumpectomy due to breast cancer 13 years previously. Arrived to the ER with neurological changes and a brain CT withot contrast performed in another hospital the erlier same day, showing a space occupaying lesion in the right parietal lobe .
Futher investigation and an enhanced brain CT-showing a ring enhancing lesion suspected to be a metastatic lesion
A chest and abdominal CT was performed a few weeks before showing a right sided beast tumor and a hyodens lesion at the pancreatic head
those findings suspected a recurrent right sided breast mass with a second primary to the pancreas or metastatic spread of the brast tumor to the abdominal cavity and to the brain.
Ultrasound examination of the right breast showed a 2.5 cm hypoechoic lesion with lobulated borders. Ultrasound guided biopsy with the pathological result showing triple negative Invasive ductal carcinoma.
Futher investigation of the pancreatic lesion with EUS and FNA showed adenocarcinoma of the pancreas.
Following FNA results of the pancreas showing adenocarcinoma ,the case was revised and a decision was made to futher investigate the tissue cores of the breast tissue, including additional immunostaning.
tumor cells werepositive for cytokeratin 19 and negative for GATA3, as well as ER,PR,Her2
These findings favor the diagnosis of metastatic poorly differentiated adenocarcinoma of pancreatic orgin.
Conclusion: We accepted the first tissue diagnosis(IDC) from the breast lesion since this is the most common breast cancer and one of the most common sites of metastatic lesion occuring to the brain
In aprevious diagnosed breast cancer patient,a recurrent tumor is not uncommon,it occurs in approximately 19 % of women once diagnosed with breast cancer
Therefor the secondary histopathological revision of the core sample taken from the breast lesion showin metastatic adenocarcinoma of pancreatic orging was surprising.
