Extensive Late Metastases of the Genital Tract by Breast Carcinoma

A 43 year-old woman who have had radical hysterectomy with axillary lymph node dissection, for a grade III infiltrative ductal adenocarcinoma of the breast in 1994, presented with right flank pain and right lower quadrant pain. Immunohistochemistry studies of the breast tissue showed diffuse intense ER positiveness. During followup; very early supraclavicular lymph node metastasis, metastasis in the jugular region, on the sternocleidomastoid muscle, and on the sternum were identified, and treated with combined chemotherapy and radiotherapy. On gynecologic examination internal genital organs were fixed, and immobile as a conglomerate mass, and ultrasonography revealed precaval enlarged lymph nodes, and grade I bilateral hydroutereonephrosis. Abrupt elevations in tumor antigens, CEA and CA15-3, were noteworthy. At laparotomy metastatic process involving the genital tract was observed, and debulked. Histopathologic examination revealed metastatic breast carcinoma involving the left ovary, fallopian tubes, myometrium, endometrium and cervix showing weak staining for estrogen and progesterone receptors.