AN OCCULT BREAST CANCER DEVELOPED AFTER CRANIOTOMY FOR METASTATIC BRAIN TUMOR

Abstract

This paper presents a case occult breast cancer developed 4 years after a craniotomy for a metastatic brain tumor. A 43-year-old female was diagnosed as having a right lobe brain tumor. Craniotomy for the brain tumor was performed. Histopathologically it was metastatic adenocarcinoma. Careful examinations of the thyroid, lung, breast, digestive organs, uterus and ovary failed to detect the primary origin. Tumor makers including CEA, CA15-3, CA125, and CA19-9 were in normal ranges. Four years later, she was admitted to the hospital for a minute general examination. A tumor (4.8×3.0 cm) was palpable in the AB area of the right breast and chest CT examination revealed parasternal lymph node metastasis invaded the chest wall (T2aN1bM1, stag IV). After preoperative chemotherapy, a right radical mastectomy with chest wall resection and lymph node resection was performed. Reconstruction for the chest wall defect was performed with double pedicled transverse rectus abdominis musclecutaneus flap. Clinicopathological studies confirmed that the right breast cancer was the primary origin of the metastatic brain tumor. This case of breast cancer in which the metastatic lesion of the brain was precedently detected is presented here with a review of the literature.