Abstract
BackgroundInvasive ductal carcinoma (IDC) of the breast usually metastasizes to the lungs, liver, bones and brain. Solitary adrenal metastasis is extremely rare. Due to the rarity of this condition, the optimal treatment is unclear. We report the first case of IDC of the breast metastasizing solely to the adrenal gland after a modified radical mastectomy but having a long-term disease-free survival while treated merely by a left adrenalectomy.Case presentationA 64-year-old woman was found a left adrenal mass on a follow- up visit two years after taking a right modified radical mastectomy for the breast cancer. She was subsequently given a left adrenalectomy. Postoperative histopathology findings were compatible with invasive ductal carcinoma (IDC) of the breast. Due to the patient's refusal, no further treatments were offered after the adrenalectomy. The patient now is still alive and has no sign of relapse. Survival time after taking the right modified radical mastectomy and the left adrenalectomy is more than five years and three years, respectively.ConclusionThis is the first case of a patient with solitary, metachronous adrenal metastasis from IDC of the breast to be reported. For patients in this condition, complete removal of metastasized organ may translate into survival benefit.
Highlights
Invasive ductal carcinoma (IDC) of the breast usually metastasizes to the lungs, liver, bones and brain
This is the first case of a patient with solitary, metachronous adrenal metastasis from IDC of the breast to be reported
Adrenal metastasis of breast cancer is generally associated with infiltrating lobular carcinomas (ILC) and often accompanied by synchronous multiorgan metastases[3]
Summary
Invasive ductal carcinoma (IDC) is the most common type of the breast cancer, which has been reported to constitute approximately 70-85% of all invasive breast carcinomas[1]. We report the first case of IDC of the breast metastasizing solely to the adrenal gland after a modified radical mastectomy but having a long-term disease-free survival treated merely by a left adrenalectomy. Histopathological examinations confirmed a metastasis event from IDC of the breast as same characteristics of the tumor cells were observed (Figure 2B, C). Immunohistochemical staining on metastasized adrenal tumor showed negative for estradiol, progesterone receptors and P53, but positive for C-erbB-2 (Figure 3A), gross cystic disease fluid protein-15 (GCDFP-15) (Figure 3B) and mammaglobin (Figure 3C). The patient is currently in good condition and being followed up at the outpatient clinic without further evidence of recurrence She has survived for more than three years since the left adrenalectomy for isolated adrenal metastasis from IDC of her right breast
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