Breast Metastasis of Ovarian Origin

Abstract

Secondary mammary cancers are rare tumors and represent only 0.3% of all malignant breast tumors. Mammary metastases of ovarian origin are rarely reported in the literature. We report the case of a 48-year-old woman with antecedent peritoneal tuberculosis treated 2 years ago. She had chronic pelvic and lower back pain associated with weight loss and general impairment. Pelvic examination showed a bilateral mobile and painful latero-uterine mass. Serum CA 125 levels were elevated. Abdomino-pelvic ultrasound and CT scans showed the presence of a bilateral para-uterine pelvic liquid mass evoking a hydrosalpinx. The patient received a laparoscopy with an ovarian biopsy. The morphological and immunohistochemical aspect points to an invasive and sparsely differentiated primary ovarian adenocarcinoma. The patient benefited from 4 chemo treatments with a good radiological and biological response. Two years after the onset of symptoms, the patient presented a solitary 3-cm nodule in the left breast without associated axillary adenopathies. At mammography, the tumor was classified as ACR 4 and biopsies were performed. The histological study showed malignant tumor proliferation with the same morphological and immunohistochemical characteristics as an ovarian tumor. The patient was lost to follow-up after the diagnosis of breast metastasis.