Metastatic malignant pleural mesothelioma to the breast

Our plain-English summary of Metastatic malignant pleural mesothelioma to the breast, by S.M. Sheen-Chen, Y.W. Liu, H.L. Eng, et al (Southern Medical Journal, 2006).

The study

• Authors: S.M. Sheen-Chen, Y.W. Liu, H.L. Eng, C.C. Huang, S.F. Ko
• Journal: Southern Medical Journal
• Published: 2006;99(12):1395-7
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 51-year-old woman suffered from dyspnea for several days before she came to an outside clinic for help. Pleura biopsy was performed and the histologic diagnosis was malignant mesothelioma. Sixteen months later, a palpable left breast lump was noted. Physical examination revealed a firm mass in the breast, measuring about 4 x 3.5 cm in size. Breast sonography showed a hypoechoic mass about 3 x 2 x 1.5 cm in size with irregular border in the middle part of the left breast. A mammogram revealed a speculated mass. Chest computed tomography was also performed, which revealed a large pleural mesothelioma and an irregular breast lesion. Incisional biopsy of the left breast lump was performed and histologic examination revealed an infiltrative growth of neoplastic polygonal cells bearing hyperchromatic and pleomorphic nuclei and a small amount of pale, pinkish cytoplasm. Further immunohistochemical study was performed and the tumor cells were positive for low and high molecular weight cytokeratin, thrombomodulin and focally positive for CEA. The final histologic diagnosis was metastatic malignant mesothelioma.

In plain English

This article was a case report about one 51-year-old woman, from the Departments of Surgery, Pathology, and Diagnostic Radiology at Chang Gung Memorial Hospital, Kaohsiung, Taiwan. The article did not describe any asbestos exposure. After several days of shortness of breath, she had a chest CT scan showing nodular thickening of the pleura (the lining around the lung) of the left lung. A pleural biopsy was diagnosed as malignant mesothelioma. Sixteen months later she came to the hospital with a lump in her left breast. A mammogram showed a spiculated (spiky-edged) mass, ultrasound showed a mass with an irregular border, and a chest CT showed a large pleural mesothelioma and an irregular breast lesion. A biopsy of the breast lump, with special tissue stains, led to a final diagnosis of metastatic malignant mesothelioma, meaning the cancer had spread to the breast. The authors stated that, to their knowledge, this was the first such case reported. They noted that these image findings differed from most breast metastases. They concluded that breast metastases should not be mistaken for primary breast cancer.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (one patient)
• Who was studied: One 51-year-old woman, treated at Chang Gung Memorial Hospital, Kaohsiung, Taiwan (the authors' institution); the date of care is not given
• Main results:
  • At first presentation, chest CT showed nodular thickening of the pleura of the left lung, and pleural biopsy was diagnosed as malignant mesothelioma
  • Sixteen months later, the patient presented with a palpable left breast lump
  • The mammogram showed a spiculated mass, and breast ultrasound showed a hypoechoic mass with an irregular border in the middle part of the left breast
  • Chest CT showed a large pleural mesothelioma and an irregular breast lesion
  • On incisional biopsy of the breast lump, the tumor cells were positive for low and high molecular weight cytokeratin, thrombomodulin, calretinin and WT-1, and focally positive for CEA. The final diagnosis was metastatic malignant mesothelioma
  • The authors stated that these image findings had, to their knowledge, never been reported for mesothelioma that had spread to the breast. They suggested this was probably due to more fibrous tissue forming around the lesion
  • Because of her history of pleural mesothelioma, incisional biopsy was done first, and the authors stated that an unnecessary mastectomy was avoided
• The authors' conclusion: The authors concluded that secondary cancer spreading to the breast is uncommon but does occur, and that the images of pleural mesothelioma spread to the breast differ somewhat from most breast metastases. In their view, incisional or needle biopsy can help tell the two apart, and breast metastases should not be mistaken for primary breast carcinoma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Dyspnea, Pleura, Biopsy, Malignant Mesothelioma, Pleomorphic.

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