Solitary breast metastasis from renal carcinoma. A case report

Metastasis to the breast are rare. A case of solitary breast metastasis from renal carcinoma is reported. A 75-year-old woman presented with a 4.5 cm, non-tender, mobile, well circumscribed lump in the upper quadrants of the right breast in march 1995. In September 1988 she had undergone right nephrectomy for a renal adenocarcinoma. Mammography revealed a mass with irregular borders and a fine needle aspiration biopsy was non diagnostic. An excisional biopsy revealed a breast metastasis from clear cell adenocarcinoma. Staging showed no evidence of further metastatic disease. The patient was disease-free until October 1999 when a liver ultrasound revealed a 4-cm metastasis and an abdominal CT scan 3 metastatic lesions in adrenal glands and duodenum. The patient died in December 2000. The recognition of breast neoplasm as being metastatic is important to prevent unnecessary radical surgery and to ensure appropriate therapy. Clinical and radiological diagnosis is not simple. In the case reported, in presence of a non-diagnostic cytology, the decision to proceed with an excisional biopsy permitted to avoid unnecessary radical surgery. The rare possibility that a breast lump is a metastasis should be kept in mind by physicians, radiologists and pathologists, in order to ensure appropriate treatment