Shaimaa Shamoun* and Ahmed N Shamout
Department of Clinical Oncology and Radiation Therapy, Al-Bashir Hospital, Al-Ashrafiyah, Amman, JordanFulltext PDF
A 68 years old female, was diagnosed as a case of right breast cancer in 2013. Modify Radical Mastectomy (MRM) was done and the pathology report showed Invasive Ductal Carcinoma (IDC), stage T3N3M0. Immunohistochemistry (IHC) study revealed (Triple positive). Patient refused to treat by chemotherapy. Patient was given Herceptin 440 mg 16 cycles for one year, Aromacin tab for 5 years and 50 gray/25 fractionation radiation therapy was applying on right breast. After one year and half, patient complained from severe diarrhea 8 times per day watery contents, vomiting and suffered from lower abdominal pain. PET scan for whole body on October/2014 was done the result showed ascending colon is highly suspicious for malignancy and moderately hypermetabolic left adrenal mass. Subtotal colectomy surgery was done, the pathology report of biopsy revealed low grade malignant neuroendocrine neoplastic lesion stage of T3N1M0 physician prescribed sandostatin LAR 20 mg monthly due to neuroendocrine lesion. On Jan/2016, cancer recurrence in the same right breast, IHC revealed ER+, PR-, Her 2+, physician decided to change aromacin to faslodex 250 mg s.c for 6 cycles. Radiation therapy was applied 20 gray/10 fractionation on scar. On may/2016, CAP-CT scan result revealed two enlarged left axillary L.N and left soft tissue density adrenal mass (3.0*2.3). Excisional lymph node was done which revealed IDC, ER+, PR-, Her2+. Physician decided to discontinue faslodex and switch to aromacin 20 mg monthly. CAP-CT which was done on Feb /2017; single left axillary L.N 1 cm, small hypodense lesion (spleen 4 cm), left adrenal lesion (2.2*2.6 cm) and osteolytic lesion were noted in iliac areas, so the physician considered those results a metastatic areas from breast and prescribed tykerb 84 tab, Patient now on (sandostatin 20 mg I.M, Herceptin 440 mg, aromacin tab and tykerb tab) monthly, zometa 4 mg q3 months, patient now still on follow up with a good condition.
Breast cancer; Neuroendocrine tumor; Gene; Adrenal gland; Second primary
Shamoun S, Shamout AN. A Case Report of Two Primary Cancer; Breast Cancer with Adrenal Gland Metastatic and Second Primary Neuroendocrine Tumor in Colon; A Rare Case in AlBashir Hospital. Oncol Case Report J. 2018;1(1):1001.