title: Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report.
abstract: BACKGROUND
  Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma.
  
  
  METHODS
  A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue.
  
  
  CONCLUSIONS
  We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. m-toyo@med.tohoku.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Toyoshima
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. soredemokitamichi1119@yahoo.co.jp.|Department of Obstetrics and Gynecology, Self-Defense Force Sendai Hospital, Sendai, Japan. soredemokitamichi1119@yahoo.co.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Iwahashi
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. tshima@snh.go.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. athayasaka@med.tohoku.ac.jp.|Department of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Japan. athayasaka@med.tohoku.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hayasaka
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. zipperxxxty@snh.go.jp.
authors.forename: Takako
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. hmakino@snh.go.jp.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Makino
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. fuji3-saorin5@herb.ocn.ne.jp.
authors.forename: Saori
authors.initials: S
authors.lastname: Igeta
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. rui_s@tim.hi-ho.ne.jp.
authors.forename: Rui
authors.initials: R
authors.lastname: Matsuura
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. ishigaki@snh.go.jp.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Ishigaki
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. akagik@snh.go.jp.
authors.forename: Kozo
authors.initials: K
authors.lastname: Akagi
authors.affiliation: Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan. sakura02@shn.go.jp.
authors.forename: Junko
authors.initials: J
authors.lastname: Sakurada
authors.affiliation: Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan. hirosuz@snh.go.jp.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. y-kou-m@mtb.biglobe.ne.jp.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Yoshinaga
mesh_terms: D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D002352:Carrier Proteins / Q000032:analysis; D003131:Combined Modality Therapy; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007889:Leiomyoma / Q000628:therapy; D026901:Membrane Transport Proteins; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000556:secondary* / Q000628:therapy
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D009570:Nitriles; C488892:PIP protein, human; D014230:Triazoles; D000077384:Anastrozole