Ahmet N. Sanli1, Kadri Altundag2
1Department of General Surgery, Silivri State Hospital, Istanbul, Turkey.
2MKA Breast Cancer Clinic, Tepe Prime, Ankara, Turkey.
Abstract
Dear Editor,
Metastasis to the salivary gland is rare. The parotid is the most commonly involved site among the salivary glands. Breast cancer metastasis to the parotid gland has been rarely reported in the literature, and relatively few case reports have described the imaging findings [1, 2]. The thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2% [3]. A 59-year-old female patient was diagnosed with locally advanced left breast cancer with luminal B subtype in May 2011. She received four cycles of neoadjuvant cyclophosphamide-epiribucin5-fluorouracil chemotherapy regimen and underwent left modified radical mastectomy with stage pT1N3M0 disease. She then received two cycles of adjuvant doxorubicin and docetaxel and subsequent adjuvant radiotherapy. She was on adjuvant letrozole treatment for about 6 years. Due to increased tumor marker levels, PET-CT scan and neck MRI were performed and showed nodules both in the right parotid gland and thyroid. FNAB and trucut biopsy from thyroid and parotid, respectively, revealed metastatic breast cancer with luminal B subtype in both sites in December 2020. She then started fulvestrant and palbociclib. On her last visit in October 2021, PET-CT scan showed no evidence of metastases. She is still continuing to receive fulvestrant and palbociclib. We reported a case of synchronous breast cancer metastases both to the parotid and the thyroid glands for the first time in the literature which highlights that thyroid and parotid metastases should be considered in a patient with thyroid and parathyroid lesions in combination with a history of breast carcinoma.
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