Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare subtype of invasive breast cancer. Prognosis is excellent with low rates of recurrence and metastatic disease compared with other triple-negative forms of breast carcinoma and other non-breast forms of ACC. We present a case of a 63-year-old female with metastatic disease in the clavicle 13 years after excision of the breast primary. Metastasis to bone is rare, and this is the first case described in the clavicle. There are no specific radiological features of breast primaries but imaging usually reveals a circumscribed mass, often without microcalcifications. Histology is similar to that of non-breast forms of ACC. Mastectomy or wide local excision is curative in virtually all cases without lymph node involvement. However, as our case demonstrates, the presence of bone pain with a history of ACC of the breast should prompt musculoskeletal imaging. Discussion at a multidisciplinary team meeting is essential for accurate diagnosis.
Highlights
CASE REPORT A 63-year-old female presented in 2016 with pain in her left clavicle while out walking her dog
Adenoid cystic carcinoma (ACC) of the breast is a rare subtype of invasive breast cancer, making up less than 0.1% of all cases.[1,2,3,4]
She had a history of grade I, node negative, triple receptor negative ACC of the left breast, which was treated with mastectomy in 2003
Summary
CASE REPORT A 63-year-old female presented in 2016 with pain in her left clavicle while out walking her dog She had a history of grade I, node negative, triple receptor negative ACC of the left breast, which was treated with mastectomy in 2003. Eight years later she was diagnosed with a new primary tumour in the contralateral (right) breast. A radiograph of the left clavicle showed evidence of an expansile destructive lesion at its medial end (Figure 1) This finding, in addition to the soft tissue invasion, was confirmed on CT (Figure 2), bone scintigraphy (Figure 3) and PET-CT (Figure 4). The patient is undergoing adjuvant radiotherapy to the area
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