Title: Carcinoma Cervix with A Breast Swelling - Metastasis or A Metachronous Primary? - A Rare Case Report
Authors: Dr Rashmi. C. Shekar, Dr Iqra Tajammul, Dr G. Joseph Benjamin, Dr M Vishnu Priya
DOI: https://dx.doi.org/10.18535/jmscr/v10i12.01
Abstract
Carcinoma cervix, one of the most common gynaecological cancer, rarely presents with solitary metastasis to the breast. Here we present a case of,60-year-old lady with chief complaints of post-menopausal bleeding since4 months & white-discharge since 2months, on further examination she was diagnosed with large-cell-non-keratinising-squamous-cell-carcinoma of cervix, stage IIB. She was treated with external-beam-chemoradiotherapy of dose 50Gy in 2 5fractions in 2Gy/fraction along with cisplatin 40mg/m2 followed by intracavitary-high-dose-rate brachytherapy of dose 7Gy once weekly for three weeks. Patient had complete response & was on regular follow-up for 8years when she developed a lump in the left breast of size 2*1.5cm in the upper-outer-quadrant, confirmed on PET- CT scan. Histopathology of the swelling along with immunohistochemical staining confirmed it to be a metastatic deposit of squamous-cell-carcinoma, p16 positive & treated with palliative chemotherapy with paclitaxel+ carboplatin for 6cycles with complete response on post-chemotherapy imaging. Now the patient is in remission and close follow up for 1year. Swelling in the breast presents with difficulty in clinical diagnosis requiring histopathological and immuno-histochemical staining for confirmation of secondary-deposit/another metachronous primary. This makes it important for reporting of such cases to aid in development of both diagnostic and managing modalities.
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