2012 Volume 26 Issue 7 Pages 801-807
A female in her fifties with solitary pulmonary metastasis of breast cancer 26 years after initial surgical treatment is reported. At 35 years old, she underwent surgical treatment for breast cancer. Twenty-six years later, she complained of hoarseness and was pointed out to have a solitary mass of the left lung lower lobe on a chest radiograph. Under a diagnosis of non-small cell lung cancer with clinical-T4N2M0, she successfully received neoadjuvant chemotherapy, after which she underwent left pneumonectomy. The pathological diagnosis based on hematoxylin and eosin sections was pulmonary adenocarcinoma with lymph node metastases at the subcarinal lymph node. Four years after left pneumonectomy, a solitary brain tumor appeared, which was surgically removed. The pathological findings were compatible with a lung tumor; however, the immunohistological findings showed a positive result for estrogen receptor, progesterone receptor, human epidermal growth factor receptor type 2, and mammaglobin 1, and a negative result for thyroid transcription factor 1 and surfactant protein A, resulting in a final diagnosis of metastasis for both the pulmonary and brain tumors from breast cancer. While solitary pulmonary metastasis of breast cancer over 25 years after the initial treatment is uncommon, it should be kept in mind that lung adenocarcinoma with a past history of breast cancer should be examined based on multiple immunohistochemical stainings.
