title: Metastasis at a tracheostomy site as the presenting sign of late recurrent breast cancer.
abstract: BACKGROUND
  Metastasis in a tracheostomy site occurs rarely, usually from head and neck primary tumors. Breast cancer relapse to a tracheostomy has not been described to date.
  
  
  RESULTS
  A 71-year-old women presented with symptoms typical of central airway obstruction, 10 years after mastectomy for breast cancer. Fifteen months before admission, when cancer follow-up was negative, she also had surgery for cerebral aneurysm and a tracheostomy. On admission, CT showed a solid mass infiltrating the tracheostomy tract and projecting into the airway. Tracheal obstruction palliation was achieved by laser resection of the endotracheal growth and stenting. Histology documented breast cancer metastasis.
  
  
  CONCLUSIONS
  Tracheostomy site metastasis was the presenting sign of late-onset relapse of breast cancer. This case supports the concept of surgery-driven interruption of micrometastatic cancer dormancy, in that the initial recurrence developed in a tracheostomy that was surgically created several years after resection of the primary tumor.
authors.affiliation: Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rotolo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Dominioni
authors.forename: Lavinia
authors.initials: L
authors.lastname: De Monte
authors.forename: Valentina
authors.initials: V
authors.lastname: Conti
authors.forename: Stefano
authors.initials: S
authors.lastname: La Rosa
authors.forename: Andrea
authors.initials: A
authors.lastname: Imperatori
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods; D018270:Carcinoma, Ductal, Breast / Q000556:secondary* / Q000601:surgery; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008408:Mastectomy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors; D014134:Tracheal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology; D014139:Tracheostomy
keywords: breast cancer; dormancy; laser resection; metastasis; tracheostomy