title: Metastatic breast carcinoma of the abdominal wall muscle: a case report.
abstract: Metastasis from breast carcinoma is an uncommon occurrence in skeletal muscle, compared to local invasion into muscle from direct tumor spread. A 49-year-old woman was referred to our hospital with an 8.5-cm mass in the right breast. Core needle biopsy revealed metaplastic carcinoma with squamous metaplasia. The mass was rapidly growing and metaplastic, so mastectomy with dissection of axillary lymph nodes was performed. Pathological examination showed metaplastic carcinoma, histological grade 3, triple negative, and a MIB-1 labeling index of 80%. Six months postoperatively, during adjuvant chemotherapy treatment, she reported numbness and pain in the right lateral thigh and a mass in the right lower abdomen. Computed tomography revealed multiple lined masses in the abdominal wall and iliac muscle. Core needle biopsy showed metastatic breast carcinoma. Radio- and chemotherapy were administered, but the mass in the muscle became enlarged. To control her pain, a combined treatment with morphine, fentanyl, ketamine, antiepilepsy drug, and NSAIDs was administered. Liver metastasis appeared 9 months (15 months postoperatively) after recognition of muscle metastasis, and the patient died 16 months postoperatively. Skeletal muscle metastasis is uncommon, and therapeutic intervention is mainly palliative. The most common symptom of skeletal muscle metastasis is pain; thus, pain control is a pivotal goal of treatment.
authors.affiliation: Department of Breast Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan, a.ogiya@scchr.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogiya
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takahashi
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Sato
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kubo
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishikawa
authors.forename: Mariko
authors.initials: M
authors.lastname: Kikutani
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tadokoro
authors.forename: Kumiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Uematsu
authors.forename: Junichiro
authors.initials: J
authors.lastname: Watanabe
authors.forename: Masako
authors.initials: M
authors.lastname: Kasami
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamasaki
mesh_terms: D000008:Abdominal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D034861:Abdominal Wall / Q000473:pathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D059408:Pain Management
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal