Abstract
In this paper we report two interesting cases of metastatic ovarian cancer. The first case is a patient who developed rectal and breast metastases mimicking an inflammatory breast cancer. In the second case, subclinical breast and axillary lymph node metastases were revealed by PET/CT. Metastases in the breast originating from solid tumors are extremely rare. The ovarian primitive is the fourth most common origin. The occurrence of breast metastasis is associated with an advanced disease and a poor prognosis. Their incidence is increasing since they are found more often due to better imaging techniques and to better treatment that, accordingly, improve patients’ survival. Thus, unusual sites of metastases are more and more reported. Indeed, some authors reported the occurrence of colorectal metastases from ovarian cancer. However, they remain much less frequent.
Highlights
In this paper we report two interesting cases of metastatic ovarian cancer
It was discovered that basal-like tumors share the same driving mutations, i.e. they are genetically similar to high grade serous ovarian carcinomas[9]
In this paper, we have described the sixth case and the first case with both breast-and rectal metastases from a serous papillary ovarian carcinoma. To our knowledge, this is the first case reported in literature that describes both rectal- and breast metastases mimicking an inflammatory breast cancer, that derived from a serous papillary ovarian cancer
Summary
Breast metastases from a non-mammary origin remain anecdotal. Some retrospective studies of patients with metastatic cancers from different primaries, report an incidence ranging from 0.1 to 1.3%2–4. When the PET-CT was used for the work-up among patients with FIGO stage IIC-IV ovarian cancer, a supradiaphragmatic lymph node disease was detected in 67% of cases even if conventional imaging had showed no metastasis[12]. Serous histology can be associated with microcalcifications so differential diagnosis can sometimes be difficult[8,17] These imaging techniques are unable to formally distinguish a primary breast cancer from a metastasis. Wilm’s Tumor 1 Receptor WT1 has been described as an interesting marker to make the differential diagnosis between a metastasis from ovarian origin and a breast primary, some breast cancers have been found positive for WT118,19. In this paper, we have described the sixth case and the first case with both breast-and rectal metastases from a serous papillary ovarian carcinoma
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