Metastatic ductal breast carcinoma in meningioma: A case report

Abstract

Objective: Meningiomas and breast cancers statistically are very common tumours among women. However, metastasis from breast carcinoma into an intracranial meningioma is extremely rare. We present a case of 66-years-old female patient diagnosed with breast tumour on physical exam 2 years prior, but refusing further treatment at that time. Method: After incidental fall from height the patient was admitted with vertigo and headaches. CT and MRI was performed which revealed temporoparietal extra-axial brain tumour measuring 7,4x6,3x4,8 cm and small diffuse post-contrast lesions suspicious for sarcoidosis. Surgery with fragmented excision and brain biopsy was performed. Gross examination showed hard white tumour parts with uniform cut surface. Standard procedure for histology and immunohistochemistry was made. Results: Microscopically the tumour was composed of spindle-shaped fibroblastoid cells with small areas of edema. On one sample from totally fifteen taken and on the samples from the brain biopsy, micro-metastatic foci resembling ductal breast carcinoma were detected. Immunohistochemical positivity for CK7, E-cadherin, ER, PR and strong HER with high Ki-67, confirmed the diagnosis. Conclusion: Tissue sampling plays great role in macroscopically undetectable lesions and patients without desire for cooperation. It is important to avoid overlooking the diagnosis of metastatic disease, taking into consideration the requirements for specific treatment strategy.