title: Malignant neoplasm in the axilla of a male: suspected primary carcinoma of an accessory mammary gland.
abstract: A 58-year-old Japanese male patient visited our hospital for evaluation of an elastic hard mass, measuring 80 x 50 mm, in the right axillary area. Incisional biopsy for suspected malignancy was performed, and histopathologic examination by hematoxylin-eosin (H&E) staining yielded a diagnosis of poorly differentiated adenocarcinoma metastatic from an unknown primary. As the tumor was immunohistochemically positive for both ER and PgR, metastatic breast cancer was strongly suspected. Ultrasonography, CT, and MRI revealed no evidence of tumors in the bilateral mammary glands. Detailed examination of the head and neck region, lung, and upper and lower gastrointestinal tract also revealed no evidence of a primary tumor. After chemotherapy, the patient underwent tumor resection with axillary lymph node dissection. On the basis of the histological features of H&E-stained specimens and immunohistochemistry of the resected tumor, this case was diagnosed as breast cancer of unknown origin in a male. The tumor could have been an axillary lymph node metastasis from an occult breast carcinoma, or primary cancer arising in an accessory mammary gland.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, 4-11-1 Izumi-Honcho, Komae, Tokyo 201-8601, Japan. takeyama@jikei.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Isao
authors.initials: I
authors.lastname: Tabei
authors.forename: Osamu
authors.initials: O
authors.lastname: Fukuchi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nogi
authors.forename: Satoki
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Ken
authors.initials: K
authors.lastname: Uchida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000628:therapy; D001365:Axilla; D018567:Breast Neoplasms, Male / Q000473:pathology* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed