Synchronous ipsilateral carcinoma of the accessory mammary gland and primary lymphoma of the breast with subsequent rectal carcinoma: report of a case.

Hide Kasai,Naohiko Koide,Yoshinori Koyama,Akihiro Iijima,Shigeyoshi Kumeda,Hisashi Shimojo,Akihiro Nishikawa

doi:10.1186/1477-7819-12-286

Hide Kasai, Naohiko Koide + Show 5 more

Open Access

https://doi.org/10.1186/1477-7819-12-286

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Abstract

A case of synchronous carcinoma of the accessory mammary gland and primary breast lymphoma with subsequent rectal carcinoma has not been reported previously. We present a very rare case of primary non-Hodgkin lymphoma of the left breast diagnosed simultaneously with invasive lobular carcinoma of the left axillary accessory mammary gland and rectal adenocarcinoma. An 82-year-old Japanese woman presented with two palpable masses on the left chest wall. She was given a diagnosis of suspected breast malignant tumor and axillary accessory mammary gland. She underwent excision of the axillary accessory mammary gland and left mastectomy with axillary lymph node dissection. Histopathological examination revealed diffuse large B-cell lymphoma of the breast and invasive lobular carcinoma of the axillary accessory mammary gland with lymph nodes metastasis. Three months after the surgery, primary rectal adenocarcinoma was also detected by F-18 fluorodeoxyglucose positron emission tomography. Hartmann’s operation was performed, since which time the patient has been doing well.

Highlights

The synchronous occurrence of multiple neoplastic processes is uncommon, and coexistence with cancer and lymphoproliferative diseases of the breast is unusual [1]
We present an extremely rare case of synchronous primary non-Hodgkin lymphoma (NHL) of the left breast with invasive lobular carcinoma of the ipsilateral axillary accessory mammary gland, with subsequent rectal adenocarcinoma
Since fine-needle aspiration cytology of the breast tumor revealed that it could be categorized as being suspected of malignancy, left mastectomy with axillary lymph node dissection and excision of the axillary accessory mammary gland were performed

Summary

Background

The synchronous occurrence of multiple neoplastic processes is uncommon, and coexistence with cancer and lymphoproliferative diseases of the breast is unusual [1]. We present an extremely rare case of synchronous primary non-Hodgkin lymphoma (NHL) of the left breast with invasive lobular carcinoma of the ipsilateral axillary accessory mammary gland, with subsequent rectal adenocarcinoma. Fine-needle aspiration cytology of the breast tumor revealed that it could be categorized as being suspected of malignancy, left mastectomy with axillary lymph node dissection and excision of the axillary accessory mammary gland were performed. Histopathology of the axillary tumor revealed ductal structures, fibrous tissue, fat tissue, and infiltrating cancer cells (Figure 2). The cancer cells were positive for cytokeratin AE1/AE3 and negative for E-cadherin They exhibited a positive reaction to anti-estrogen receptor and anti-progesterone receptor, but were negative for HER2. These findings were consistent with invasive lobular carcinoma. There has been no recurrence or distant metastasis in the 7 months of follow-up since the last surgery

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