A unique case of total metastatic lobular breast carcinoma, originating from diffused microcalcifications, presented in a postmenopausal woman, without clinical manifestations

Athanasios Douskos; Aris Giannos; Sofoklis Stavrou; Maria Sotiropoulou; Eleni Feida; Constantine Dimitrakakis; Peter Drakakis; Alexandros Rodolakis

doi:10.1016/j.ijscr.2018.01.026

A unique case of total metastatic lobular breast carcinoma, originating from diffused microcalcifications, presented in a postmenopausal woman, without clinical manifestations

Int J Surg Case Rep. 2018:44:85-89. doi: 10.1016/j.ijscr.2018.01.026. Epub 2018 Feb 12.

Authors

Athanasios Douskos¹, Aris Giannos², Sofoklis Stavrou³, Maria Sotiropoulou⁴, Eleni Feida⁵, Constantine Dimitrakakis⁶, Peter Drakakis⁷, Alexandros Rodolakis⁸

Affiliations

¹ 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].
² 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].
³ 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].
⁴ Department of Pathology, Alexandra Hospital, Athens, Greece. Electronic address: [email protected].
⁵ Department of Radiology, Alexandra Hospital, Athens, Greece. Electronic address: [email protected].
⁶ 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].
⁷ 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].
⁸ 1(s,t)OB.GYN Department, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece. Electronic address: [email protected].

Abstract

Introduction: Lobular breast carcinoma includes lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). The association of LCIS with total metastatic lobular breast cancer is very rare.

Presentation of case: We present a case of a totally metastatic lobular breast cancer in an asymptomatic 64-year-old postmenopausal woman, with no suspicious microcalcifications in mammography. A total hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, infracolic omentectomy and appendectomy was performed along with a quadrantectomy of the upper outer quadrant of left breast, and systematic isolateral lymphadenectomy of the left axilla.

Discussion: LCIS is usually undetectable because it isn't associated with clinical abnormalities in clinical examination and is presented in mammography as microcalcifications or focal asymmetric densities. ILC histopathologic features are responsible for the high false-negative rates on mammography, leading to moderate detection sensitivity.

Conclusion: Our case is a very rare condition. No 'similar' case have been described in the literature so far.

Keywords: Case report; Invasive lobular carcinoma; Lobular carcinoma in situ; Mammography; Metastatic; Microcalcifications.