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The journal «ONCOSURGERY» 2012, Vol.4, No 3

Multiple brain metastases 18 years after radical mastectomy in male

Stepanyan МА, Rotin DL, Cherekaev VА, Golanov АV, Paklina ОV, Israelyan LА, Vetlova ЕR, Lobanova NV

NN Burdenko Research Institute of Neurosurgery, Moscow, Rusia
Contact: Stepanyan MA, e-mail:

Brain metastatic disease in a male breast carcinoma patients is a rear pathology and therefore diagnosis and treatment this pathology are extremely interesting.

Purpose and tasks. We report a rare occurrence of a brain metastatic disease in a male breast carcinoma patient and discuss options of treatment leading 18 year survival.

Material and methods. The patient, Male, Caucasian, 44 years old at the time of first presentation in June 1994, had a right breast cancer in stage рТ2N1M0. The patient underwent combine treatment – radical mastectomy, chemotherapy, radiation and hormonal therapy and survives after first presentation of a breast cancer about 18 years.

Results. After one course of CMF neoadjuvant treatment a radical mastectomy with lymph nodes dissection was done in November 1995. Radiology treatment and six courses of CMF were performed post-surgery. The patient was treated by tamoxifen during the following five years. The complex mode of treatment resulted in the long and strong remission. However, 12 years after radical mastectomy, the patient complained of lumbar pain with lower limbs irradiation. X-ray, CT and MRI showed multiple metastatic foci in both lungs, in skeletal bones. The complex treatment including several courses of radiology and chemotherapy resulted in 50% decrease of tumor nodes size in the left lung and discontinuation of the lumbal pain. During following 6 years the patient had a stabilized neoplastic process. 18 years after mastectomy appear multiple brain metastases. On May of 2012 neurosurgical removal of the right temporal metastasis was performed. Patient had stereotaxic radiosurgery on the small metastases in the right frontal lobe and received radiation treatment with median doses 15, 20 and 25 Gy on the post-operative area. The patient was discharged in good general condition without signs of neurologic deficiency.

Conclusions. Male breast carcinoma demonstrates strong estrogen and progesterone expression, as determined by the IHC staining: 91 and 76%, respectively. Hyperexpression and amplification of Her-2/neu gene is also an essential feature for male breast carcinoma. There is a plausible suggestion that application of the anti-estrogen agents (e.x. Tamoxifen) provided favorable influence and resulted in tumor progression stabilization.

KEY WORDS: male breast carcinoma, brain metastatic disease.

References

  1. Zygogianni AG, Kyrgias G, et al. Male breast carcinoma: epidemiology, risk factors and current therapeutic approaches. Asian Pac J Cancer Prev. 2012; 13(1): 15-19.
  2. Fiala L, Coufal O, et al. Male breast cancer-our experience. Rozhl Chir. 2010; 89(10): 612-618.
  3. Liu T, Tong Z, et al. Clinicopathological characteristics and survival Analysis of 87 male breast cancer cases. Breas. Care (Basel). 2011; 6(6): 446-451.
  4. Saleh FM, Ansari NP, et al. Invasive ductal carcinoma in a young male breast Mymensingh. Med. J. 2012; 21(1): 162-164.
  5. Tallón-Aguilar L, Serrano-Borrero I, et al. Breast cancer in males. Cir Cir. 2011; 79(4): 296-298.
  6. Bourhafour M, et al. Male breast cancer: a report of 127 cases at a Moroccan institution. BMC Res Notes. 2011; 29(4): 219.
  7. Gabal S, Talaat S, et al. Secretory carcinoma of male breast: case report and review of the literature. Int J Breast Cancer. 2011; 2011: 704657.
  8. Johansson I, Nilsson C, et al. Gene expression profiling of primary male breast cancers reveals two unique subgroups and identifies N-acetyltransferase-1 (NAT1) as a novel prognostic biomarker. Breast Cancer Res. 2012; 14(1).
  9. Hicks DG, Lester SC. Diagnostic pathology. Brest. 2012; 2-230.
  10. Gonzalez-Perez LM, Infante-Cossio P, et al. Mandibular metastases as first clinical sign of an occult male breast cancer. Int J Oral Maxillofac Surg. 2012 Mar 23.
  11. Gonzalez-Perez LM, Infante-Cossio P. Nasosinusal metastasis of a breast cancer in a man. Presse Med. 2010; 39(12): 1340-1342.
  12. Kertmen N, Dogan E, et al. Pure mucinous breast carcinoma with lung metastasis in a young male patient. Am Surg. 2010; 76(8).
  13. Eryilmaz MA, Igci A, et al. Male breast cancer: a retrospective study of 15 years. J. BUON. 2012; 17(1): 51-56.
  14. van Rijswijk RE, van Oostenbrugge RJ, Twijnstra A. A case of brain metastases from male breast cancer responding to tamoxifen. Eur J Cancer. 1997; 33(13): 2282-2283.
  15. Nieder C, Jost PJ, Grosu AL, Peschel C, Molls M. Report of a male patient with brain metastases from breast cancer. Breast. 2003; 12(5): 345-347.
  16. Einstein DB. Metastatic cancer to the central nervous system. Oncology. 2006; 7: 1621-1634.
  17. Giordano SH, Buzdar AU, Hortobagyi GN. Breast cancer in men. Ann Intern Med. 2002; 137(8): 678-687.
  18. Goss PE, Reid C, Pintilie M, Lim R., Miller N. Male breast carcinoma: a review of 229 patients who presented to the Princess Margaret Hospital during 40 years: 1955-1996. Cancer. 1999; 85(3): 629-639.

P. 88-91

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