Skip to main content

Advertisement

SpringerLink
Log in

Metastatic seeding of colon adenocarcinoma manifesting as synchronous breast and chest wall localization: Report of a case

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Colon carcinoma rarely metastasizes to the breast and it is usually associated with a poor prognosis. Even rarer is metastatic seeding of colon cancer cells in an intramammary location after surgery. Including a primary breast malignancy in the differential diagnosis of such cases is mandatory. We report a rare case of double seeding implantation of colon adenocarcinoma inside the breast parenchyma and intercostal muscles 6 years after resection of a pulmonary metastasis from colon adenocarcinoma. The metastasis was revealed by the presence of bone metaplasia in the intercostal muscles. We discuss how negative immunostaining for estrogen receptors, progesterone receptors, and HER-2, along with the immunohistochemical pattern of cytokeratin (CK) 20+/7-/5- and CDX2-positive immunostaining, excludes a primary breast malignancy, namely, a “matrix-producing” carcinoma, from the differential diagnosis. We also present the hypothesis of a paracrine pathogenetic mechanism to explain the bone metaplasia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ho YY, Lee WK. Metastasis to the breast from an adenocarcinoma of the colon. J Clin Ultrasound 2009;37:239–241.

    Article  PubMed  Google Scholar 

  2. Fernández de Bobadilla L, García Villanueva A, Collado M, de Juan A, Rojo R, Pérez J, et al. Breast metastasis of primary colon cancer. Rev Esp Enferm Dig 2004;96:415–419.

    Article  PubMed  Google Scholar 

  3. Yeh CN, Lin CH, Chen MF. Clinical and ultrasonographic characteristics of breast metastases from extramammary malignancies. Am Surg 2004;70:287–290.

    PubMed  Google Scholar 

  4. Oksüzoǧlu B, Abali H, Güler N, Baltali E, Ozişik Y. Metastasis to the breast from nonmammarian solid neoplasms: a report of five cases. Med Oncol 2003;20:295–300.

    Article  PubMed  Google Scholar 

  5. Park SY, Kim BH, Kim JH, Lee S, Kang GH. Panels of immunohistochemical markers help determine primary sites of metastatic adenocarcinoma. Arch Pathol Lab Med 2007;131:1561–1567.

    CAS  PubMed  Google Scholar 

  6. Beatty JD, Atwood M, Tickman R, Reiner M. Metaplastic breast cancer: clinical significance. Am J Surg 2006;191:657–664.

    Article  PubMed  Google Scholar 

  7. Ninomiya J, Oyama T, Horiguchi J, Koibuchi Y, Yoshida T, Iijima K, et al. Two cases of breast cancer with cartilaginous and osseous metaplasia. Breast Cancer 2005;12:52–56.

    Article  PubMed  Google Scholar 

  8. Reis-Filho JS, Milanezi F, Steele D, Savage K, Simpson PT, Nesland JM, et al. Metaplastic breast carcinomas are basal-like tumours. Histopathology 2006;49:10–21.

    Article  CAS  PubMed  Google Scholar 

  9. Hotokezaka M, Jimi S, Hidaka H, Ikeda T, Uchiyama S, Nakashima S, et al. Factors influencing outcome after surgery for stage IV colorectal cancer. Surg Today 2008;38:784–789.

    Article  PubMed  Google Scholar 

  10. Fiori E, Galati G, Bononi M, De Cesare A, Binda B, Ciardi A, et al. Subcutaneous metastasis of pancreatic cancer in the site of percutaneous biliary drainage. J Exp Clin Cancer Res 2003;22:151–154.

    CAS  PubMed  Google Scholar 

  11. Torreggiani WC, Lyburn I, Harris AA, Zwirewich CV. Seeding of pancreatic cancer along the path of a surgical drain: case report and literature review. Can Assoc Radiol J 2000;51:241–243.

    CAS  PubMed  Google Scholar 

  12. Chapman WC, Sharp KW, Weaver F, Sawyers JL. Tumor seeding from percutaneous biliary catheters. Ann Surg 1989;209:708–713.

    Article  CAS  PubMed  Google Scholar 

  13. Verbeek PC, Van der Heyde MN, Ramsoekh T, Bosma A. Clinical significance of implantation metastases after surgical treatment of cholangiocarcinoma. Semin Liver Dis 1990;10:142–144.

    Article  CAS  PubMed  Google Scholar 

  14. Sano T, Nimura Y, Hayakawa N, Kamiya J, Kondo S, Nagino, et al. Partial hepatectomy for metastatic seeding complicating pancreatoduodenectomy. Hepatogastroenterology 1997;44:263–267.

    CAS  PubMed  Google Scholar 

  15. Inagaki M, Yabuki H, Hashimoto M, Maguchi M, Kino S, Sawa M, et al. Metastatic seeding of bile duct carcinoma in the transhepatic catheter tract: report of a case. Surg Today 1999;29:1260–1263.

    Article  CAS  PubMed  Google Scholar 

  16. Shimizu Y, Yasui K, Kato T, Yamamura Y, Hirai T, Kodera Y, et al. Implantation metastasis along the percutaneous transhepatic biliary drainage sinus tract. Hepatogastroenterology 2004;51:365–367.

    PubMed  Google Scholar 

  17. Sakata J, Shirai Y, Wakai T, Nomura T, Sakata E, Hatakeyama K. Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma. World J Gastroenterol 2005;11:7024–7027.

    PubMed  Google Scholar 

  18. Torzilli G, Cremascoli G, Cattaneo S, Stefanini P, Olivari N. Drainsite tumour recurrence after laparotomy resection for colorectal cancer. Eur J Surg Oncol 1999;25:546–547.

    Article  CAS  PubMed  Google Scholar 

  19. Behtash N, Ghaemmaghami F, Yarandi F, Andalan FA, Kanafshar N. Cutaneous metastasis from carcinoma of the cervix at the drain site. Gynecol Oncol 2002;85:209–211.

    Article  PubMed  Google Scholar 

  20. Copas PR, Spann CO, Thoms WW, Horowitz IR. Squamous cell carcinoma of the cervix metastatic to a drain site. Gynecol Oncol 1995;56:102–104.

    Article  CAS  PubMed  Google Scholar 

  21. Sugi K, Nawata K, Ueda K, Kaneda Y, Nawata S, Oga A, et al. Chest wall implantation of lung cancer at the drainage tube site: report of a case. Surg Today 1997;27:666–668.

    Article  CAS  PubMed  Google Scholar 

  22. Quecedo E, Febrer I, Martínez-Escribano JA, Navarro-Iváñez R, Aliaga A. Tumoral seeding after pericardiocentesis in a patient with a pulmonary adenocarcinoma. J Am Acad Dermatol 1994;31:496–497.

    Article  CAS  PubMed  Google Scholar 

  23. Sacchini V, Galimberti V, Marchini S, Luini A. Percutaneous transthoracic needle aspiration biopsy: a case report of implantation metastasis. Eur J Surg Oncol 1989;15:179–183.

    CAS  PubMed  Google Scholar 

  24. Janes SM, Rahman NM, Davies RJ, Lee YC. Catheter-tract metastases associated with chronic indwelling pleural catheters. Chest 2007;131:1232–1234.

    Article  PubMed  Google Scholar 

  25. Kaya H, Güllüoglu B, Aribal E. Myoepithelial differentiation in breast carcinoma. Tumori 2008;94:116–120.

    PubMed  Google Scholar 

  26. Dunne B, Lee AH, Pinder SE, Bell JA, Ellis IO. An immunohistochemical study of metaplastic spindle cell carcinoma, phyllodes tumor and fibromatosis of the breast. Hum Pathol 2003;34:1009–1015.

    Article  CAS  PubMed  Google Scholar 

  27. Werling RW, Yaziji H, Bacchi CE. Gown AM. CDX2, a highly sensitive and specific marker of adenocarcinomas of intestinal origin: an immunohistochemical survey of 476 primary and metastatic carcinomas. Am J Surg Pathol 2003;27(3):303–310.

    Article  PubMed  Google Scholar 

  28. Haque S, Eisen RN, West AB. Heterotopic bone formation in the gastrointestinal tract. West AB Arch Pathol Lab Med 1996;120:666–670.

    CAS  Google Scholar 

  29. Alper M, Akyürek N, Patiroǧlu TE, Yüksel O, Belenli O. Heterotopic bone formation in two cases of colon carcinoma. Scand J Gastroenterol 2000;35:556–558.

    Article  CAS  PubMed  Google Scholar 

  30. Imai N, Iwai A, Hatakeyama S, Matsuzaki K, Kitagawa Y, Kato S, et al. Expression of bone morphogenetic proteins in colon carcinoma with heterotopic ossification. Pathol Int 2001;51:643–648.

    Article  CAS  PubMed  Google Scholar 

  31. Komai Y, Morimoto S, Saito K, Urushibara M, Sakai K, Ikeda S. Possible involvement of bone morphogenetic protein 2 in heterotopic ossification in metastatic lesion from urothelial carcinoma of bladder. Int J Urol 2006;13:1126–1128.

    Article  PubMed  Google Scholar 

  32. Lee KS, Kim HJ, Li QL, Chi XZ, Ueta C, Komori T, et al. Runx2 is a common target of transforming growth factor beta1 and bone morphogenetic protein 2, and cooperation between Runx2 and Smad5 induces osteoblast-specific gene expression in the pluripotent mesenchymal precursor cell line C2C12. Mol Cell Biol 2000;20:8783–8792.

    Article  CAS  PubMed  Google Scholar 

  33. Naik VR, Jaafar H, Mutum SS. Heterotopic ossification in skeletal muscle metastasis from colonic adenocarcinoma: a case report. Malays J Pathol 2005;27:119–121.

    PubMed  Google Scholar 

  34. Yoshikawa H, Kameyama M, Ueda T, Kudawara I, Nakanishi K. Ossifying intramuscular metastasis from colon cancer: report of a case. Dis Colon Rectum 1999;42:1225–1227.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Human Pathology, University of Palermo, A.O.U. Policlinico “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Daniela Cabibi & Sabrina Ingrao

  2. Department of Oncology, Division of General and Oncological Surgery, University of Palermo, A.O.U. Policlinico “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Calogero Cipolla

  3. Department of Oncology, Division of Medical Oncology, University of Palermo, A.O.U. Policlinico “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Maria Rosaria Valerio

Authors
  1. Daniela Cabibi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calogero Cipolla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Rosaria Valerio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sabrina Ingrao
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cabibi, D., Cipolla, C., Valerio, M.R. et al. Metastatic seeding of colon adenocarcinoma manifesting as synchronous breast and chest wall localization: Report of a case. Surg Today 41, 242–246 (2011). https://doi.org/10.1007/s00595-009-4222-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-009-4222-3

Key words

Search

Navigation