PMC4386146_01
Chest CT scan. Massive pleural effusion and left breast mass (arrow).
cro-0008-0164-g01.jpg
PMC4386146_01_cro-0008-0164-g01.jpg
F1
Due to massive pleural effusion, a thoracoscopy for biopsies and talc pleurodesis was performed (fig. 1).
Chest CT scan. Primary lung cancer in the left upper lobe (arrow).
cro-0008-0164-g02.jpg
PMC4386146_01_cro-0008-0164-g02.jpg
F2
CT scan performed after complete pleural drainage demonstrated an upper left lobe primary lung cancer (fig. 2). Considering these thoracic findings and the lack of efficacy of chemotherapy for the breast lesion, a new breast biopsy was performed.
Breast biopsy. Histology features (a) and TTF1-positive immunostaining profile (b) for breast metastasis of the lung adenocarcinoma.
cro-0008-0164-g03.jpg
PMC4386146_01_cro-0008-0164-g03.jpg
F3
PAX8-) were consistent with breast metastasis from the lung adenocarcinoma rather than a primary breast carcinoma (fig. 3). PCR analysis of the breast lesion identified the same EGFR-activating mutation (deletion of exon 19) as in the primary lung tumor.
Chest CT scan. Objective response after 2 months of afatinib (arrow; see fig. 2 for baseline).
cro-0008-0164-g04.jpg
PMC4386146_01_cro-0008-0164-g04.jpg
F4
Major clinical and ultrasonographic reduction of the breast mass and thoracic objective response were found after 2 months of afatinib (fig. 4).