%0 Journal Article
%T Breast metastasis of primary colon cancer with micrometastasis in the axillary sentinel node: A metastasis that metastasized?
%A Tiziana Perin
%A Vincenzo Canzonieri
%A Lorenzo Memeo
%A Samuele Massarut
%J Diagnostic Pathology
%D 2011
%I BioMed Central
%R 10.1186/1746-1596-6-45
%X The demonstration of axillary lymph node micrometastasis has been possible because fine needle aspiration cytology of the breast nodule was suspicious, but not conclusive for metastasis from colon cancer, so lumpectomy with sentinel node biopsy was planned.Although no disseminated nodal metastases were evident on computerized tomography scan and ultrasonography before breast surgery, the patient developed brain metastases and deteriorated rapidly; she died 16 months after presenting with the breast mass.In conclusion, solid cancers are able to further metastasize, via well-known pathways also recognized in primary cancers such as neoplastic cell invasion of peritumoral lymphatics.The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1709104649540810 webcite.Metastasis to the breast from colon adenocarcinoma is very rare. Prognosis is poor because it is usually indicative of disseminated disease. It is important to distinguish metastatic disease from primary breast carcinoma in order to better planning the appropriate treatment [1].The three main routes of tumour metastasis are direct spread, via the lymphatic system, and blood borne. It is however a matter of debate whether metastatic deposits have an ability to produce further metastases. In literature there are very few anecdotal data and experimental models have been inconclusive [2].This case report describes a patient with breast metastasis from colon adenocarcinoma treated by lumpectomy and sentinel node biopsy. Strangely enough the sentinel node showed a micrometastasis from colon cancer. A possible interpretation of this finding might imply that distant metastases are able to further metastasize.In May 2005 a 46 year old woman underwent a sigmoid resection for colon cancer pT3 N1 M0 G2. Then she received 6 cycles of chemotherapy (FOLFOX). She remained well till April 2007 when she developed bilateral lung metastases treated with FOLFIRI and Avastin£¿ (Bevacizum
%U http://www.diagnosticpathology.org/content/6/1/45