PMC6408989_01
(a) Computerized-axial tomography showing multiple lytic vertebral metastases (arrow). (b) Positron Emission Tomography showing increased metabolic activity in the vertebral bodies and pelvis.
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August of 2015 revealed osteolytic thoracic vertebral and pelvic lesions as well as bilateral axillary adenopathy measuring up to 1.4 cm on the right and 1.1 cm on the left. A Positron Emission Tomography (PET) CT was done in October of 2015 and revealed metabolic activity in the right axilla as well as patchy radiotracer uptake involving the vertebral column corresponding to the CT findings (Figure 1).
(a) Hematoxylin and eosin stain x 200x showing fragments of bone and the bone marrow is replaced by malignant spindle and epitheloid cells. Immunohistochemical stains, 400x: (b) CK7 3, (c) GATA3, and (d) ER all positive.
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A bone biopsy of a right sacral lesion confirmed metastatic breast invasive ductal carcinoma with IHC positive for CK-7, GATA-3, ER, and PR but negative for CD45, CD138, and HER2 (Figure 2).