ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Rare Case of Breast Cancer Metastasis Mimic
Session Title
TP142 - TP142 THORACIC ONCOLOGY: RARE LUNG TUMORS/METASTATIC DISEASE
Abstract
A4924 - Rare Case of Breast Cancer Metastasis Mimic
Author Block: K. Mehrotra1, R. Dadhwal2, D. Shalonov3, S. Chauhan4, A. Shalonov4; 1Internal Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States, 2Pulmonary Medicine, Corpus Christi Medical Center, Corpus Christi, TX, United States, 3Biochemistry, Stony Brook University, Stony Brook, NY, United States, 4Pulmonary Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States.
Rare case of lung carcinoid in setting of primary breast malignancyIntroductionBreast cancer is a leading global killer of women and the second most frequently identified malignancy after lung cancer. Early detection and expedient treatment have resulted in a sharp reduction in mortality and improvement in long term survival rates. However, survivors of breast cancer remain at a higher risk for developing a second primary cancer. Prior history of breast cancer can confound the detection of second primaries in these patients.
Case Description
Here we present the case of a 66-year-old female who presented with a palpable and progressively enlarging 2.2 cm mass at the upper inner quadrant of the right breast and enlarged right axillary lymph nodes. She was given neoadjuvant hormonal treatments. Subsequent lumpectomy and axillary lymph node sampling were performed. The pathology showed moderately differentiated invasive ductal carcinoma with lobular features, Nottingham histologic grade 2 (3-3-1) with a residual size of 3.6 cm. Postoperatively the patient was given chemotherapy consisting of 4 cycles of Cytoxan and Adriamycin followed by 4 cycles of Taxol.
Two months after surgery, patient was found to have a right lower lobe lung nodular density 2.2 cm. Repeat imaging failed to show any expansion of the nodularity. She underwent PET scan, which showed hypermetabolic soft tissue nodularity in the right medial breast (SUV 2.4-3.8), right axillary lymphadenopathy (SUV 4.8-8.6) & hypermetabolic right lower lobe pulmonary nodule (0.1-4.8).
Initial differentials focused on lung cancer metastases versus primary lung malignancy. To obtain a tissue diagnosis, navigational bronchoscopy was performed for the right lower lobe nodule. The sample was found to be chromogranin positive lung carcinoid.
Discussion
Second primary cancers have an increasingly higher rate of incidence in survivors of breast cancer.
It is important to remain cognizant as a physician about the numerous possible second primary site cancers such as ovarian, lung, colon, which may present in such settings. However lung carcinoid is an extremely rare malignancy especially in setting of primary breast cancer. On their own, they account for 1-2% of lung malignancies. Rare case of lung carcinoid in setting of primary breast malignancySecond primary may present as mimics of breast cancer and further confound diagnosis, as in this case.
References•Molina-Montes, E., Pollán, M., Payer, T., Molina, E., Dávila-Arias, C., & Sánchez, M. (2013). Risk of second primary cancer among women with breast cancer: A population-based study in Granada (Spain). Gynecologic Oncology,130(2), 340-345. doi:10.1016/j.ygyno.2013.04.057
Author Block: K. Mehrotra1, R. Dadhwal2, D. Shalonov3, S. Chauhan4, A. Shalonov4; 1Internal Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States, 2Pulmonary Medicine, Corpus Christi Medical Center, Corpus Christi, TX, United States, 3Biochemistry, Stony Brook University, Stony Brook, NY, United States, 4Pulmonary Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States.
Rare case of lung carcinoid in setting of primary breast malignancyIntroductionBreast cancer is a leading global killer of women and the second most frequently identified malignancy after lung cancer. Early detection and expedient treatment have resulted in a sharp reduction in mortality and improvement in long term survival rates. However, survivors of breast cancer remain at a higher risk for developing a second primary cancer. Prior history of breast cancer can confound the detection of second primaries in these patients.
Case Description
Here we present the case of a 66-year-old female who presented with a palpable and progressively enlarging 2.2 cm mass at the upper inner quadrant of the right breast and enlarged right axillary lymph nodes. She was given neoadjuvant hormonal treatments. Subsequent lumpectomy and axillary lymph node sampling were performed. The pathology showed moderately differentiated invasive ductal carcinoma with lobular features, Nottingham histologic grade 2 (3-3-1) with a residual size of 3.6 cm. Postoperatively the patient was given chemotherapy consisting of 4 cycles of Cytoxan and Adriamycin followed by 4 cycles of Taxol.
Two months after surgery, patient was found to have a right lower lobe lung nodular density 2.2 cm. Repeat imaging failed to show any expansion of the nodularity. She underwent PET scan, which showed hypermetabolic soft tissue nodularity in the right medial breast (SUV 2.4-3.8), right axillary lymphadenopathy (SUV 4.8-8.6) & hypermetabolic right lower lobe pulmonary nodule (0.1-4.8).
Initial differentials focused on lung cancer metastases versus primary lung malignancy. To obtain a tissue diagnosis, navigational bronchoscopy was performed for the right lower lobe nodule. The sample was found to be chromogranin positive lung carcinoid.
Discussion
Second primary cancers have an increasingly higher rate of incidence in survivors of breast cancer.
It is important to remain cognizant as a physician about the numerous possible second primary site cancers such as ovarian, lung, colon, which may present in such settings. However lung carcinoid is an extremely rare malignancy especially in setting of primary breast cancer. On their own, they account for 1-2% of lung malignancies. Rare case of lung carcinoid in setting of primary breast malignancySecond primary may present as mimics of breast cancer and further confound diagnosis, as in this case.
References•Molina-Montes, E., Pollán, M., Payer, T., Molina, E., Dávila-Arias, C., & Sánchez, M. (2013). Risk of second primary cancer among women with breast cancer: A population-based study in Granada (Spain). Gynecologic Oncology,130(2), 340-345. doi:10.1016/j.ygyno.2013.04.057
