A case of occult breast cancer presenting as brain metastases

Abstract

Occult breast cancer is rarely presents with the symptoms of distant metastases, but is usually detected due to axillary LN swelling.
We report a rare case of an occult breast cancer patient whose first symptoms were from multiple brain metastases.
The patient was a 59-year-old female whose first symptoms of the disease were progressively worsening headaches and disorientation. Brain CT and MRI showed multiple metastatic tumors. Several examinations were performed, including MMG, US, CT, and GIF to detect the primary lesion ; only a right axillary lymph node swelling was identitied. Fine needle aspiration cytology of the lymph node revealed metastastatic adenocarcinoma. IHC staining of brain tumor specimens showed ER(-), PgR(-), Herceptest(3+), Mammaglobin(+), CK7(+), CK20(-), GCDFP-15(+), and E-Cadherin(-). Based on these findings diagnosed and given the characteristics of the primary lesion, multiple brain metastases without a significant primary lesion, or an occult breast cancer were.
When brain metastases with no known primary lesion are detected, especially in females, occult breast cancer should be considered as the likely origin.