Solitary Adrenal Metastasis from Breast Cancer with Unidentifiable Primary Tumor Preoperatively

Abstract

A 73-year-old woman with carcinoma of the right breast showing skin invasion and right axillary lymph node metastasis had been suspected with right lung metastasis at the age of 70 and treated with chemotherapy. She underwent total right mastectomy and right axillary dissection due to persistent bleeding from the breast mass. The condition was diagnosed as invasive ductal carcinoma, pT4bN2aM0, Stage IIIB and was estrogen receptor positive, progesterone receptor positive, and human epidermal growth factor receptor type 2 negative. She was treated with hormone therapy after surgery. A lung mass suspected as metastasis from the breast cancer was identified as squamous cell lung cancer, cT2aN3M1c, Stage IVb and was treated using tyrosine kinase inhibitor. At 72 years of age, the patient underwent thoracoscopic resection of the right lung. After 10 months, right adrenal metastasis was suspected, and right adrenalectomy was performed. However, pathological analysis revealed that the adrenal metastasis was from the breast cancer. Most adrenal metastases from breast cancer involve multiple organs, and solitary adrenal metastasis is rare. In the case of solitary metastasis, local therapy is reportedly effective in improving the prognosis. Moreover, pathological identification of the primary tumor and its pathological features allow us to explore new treatment options and improve the prognosis.