Breast – Malignant, Males, Children

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Breast-malignant, males, children

Metastases to breast

Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.

Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)

Revised: 29 September 2009

Last major update: September 2009

See also metastases to male breast

Clinical

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● Rare (1-2% of breast tumors), usually from contralateral breast (Archives 2008;132:931); also lung, melanoma, ovary, kidney, stomach, thyroid (World J Surg Oncol 2007;5:74)

● Usually occurs in patients with advanced disease

● In children, rhabdomyosarcoma (alveolar variant) is most common metastasis to breast

Case reports

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● Chordoma (APMIS 2006;114:726)

● Choriocarcinoma metastasis (AJR Am J Roentgenol 2005;184:S53)

● Colonic carcinoid (Archives 2003;127:1373)

● GI (World J Gastroenterol 2006;12:2958, Am J Clin Pathol 2004;121:884, Asian J Surg 2006;29:95)

● Lung: small cell carcinoma (Diagn Cytopathol 2009;37:208) or squamous cell carcinoma (Anticancer Res 2008;28:1299)

● Melanoma (Diagn Cytopathol 2000;22:246)

● Osteosarcoma (Australas Radiol 1999;43:108)

● Pancreatic islet cell tumor in a child (AJSP 2006;30:912)

● Renal carcinoid tumor (Am J Surg 2006;191:799, Diagn Cytopathol 2007;35:306)

● Renal cell carcinoma (World J Surg Oncol 2007;5:25)

● Retroperitoneal leiomyosarcoma (Diagn Cytopathol 2007;35:508)

● Rhabdomyosarcoma ((Pediatr Hematol Oncol 1996;13:277)

● Salivary gland tumor (Acta Cytol 2002;46:377)

● Small intestinal carcinoid #1 (Archives 2004;128:292), #2 (World J Surg Oncol 2006 Mar 27;4:15)

● Thyroid (Ann Pathol 1998;18:130)

● Various metastases may resemble inflammatory breast cancer (Breast Cancer 2008;15:315, Int J Dermatol 2007;46:303, Breast J 2009;15:176)

Gross description

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● Often superficial (in soft tissue), well-circumscribed firm nodules without skin retraction or peau d’orange

Microscopic description

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● Most important feature is that it does not resemble a primary breast carcinoma

● Usually no DCIS, although infiltrative pattern may resemble DCIS (Ann Diagn Pathol 2001;5:15)

Metastatic ovarian or peritoneal serous carcinoma to breast or axilla

● Rare but may resemble poorly differentiated ductal carcinoma or micropapillary carcinoma

● Tumors have papillary architecture, often WT1+ and GCDFP-15 negative (AJSP 2004;28:1646, AJSP 1993;17:193), although breast mucinous carcinomas may also be WT1+ (Mod Path 2008;21:1217)

Micro images

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Lung neuroendocrine carcinoma Chromogranin+ Synaptophysin+

Renal cell carcinoma

Small intestinal carcinoid (AFIP) Chromogranin+

Cytology images

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Medulloblastoma

Melanoma

Lung: small cell carcinoma

Negative stains

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● GCDFP-15, ER, PR (usually)

End of Breast – Malignant, Males, Children > Metastases to breast

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