• Frank Velez-Cubian, Robert Gabordi, Carla Moodie, and Eric Toloza.
• Chest. 2014 Mar 1;145(3 Suppl):295A.

Session TitleCancer Case Report Posters ISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: A solitary fibrous tumor (SFT) is a rare pleural neoplasm, and tumor-to-tumor metastases are unusual phenomena.Case PresentationA 64-year-old woman, with history of positron-emission tomography (PET)-negative invasive ductal carcinoma, Nottingham grade I, ER(+)/PR(+)/HER2(-), treated 6 years previously with cyclophosphamide and doxorubicin, then weekly paclitaxel. Upon progression, she underwent right simple and left modified radical mastectomies, with 9 of 11 left axillary lymph nodes involved by metastatic carcinoma, T1cN2aM0, followed by maintenance letrozole, which was stopped 6 months previously. She recently presented with increasing dyspnea, and imaging studies revealed a 2.9-cm, PET-positive (SUV 7.6) right lung mass and a 2.8-cm, PET-negative left lung mass. She underwent video-assisted thoracoscopic left lower lobe wedge resection, immediately followed by robotic-assisted video-thoracoscopic right upper lobectomy with mediastinal lymph node dissection. Operative (skin-to-skin) time was 267 min; estimated blood loss was 500 mL. She had no postoperative complications. The left chest tube was removed on postoperative day (POD)#1; the right chest tube was removed on POD#4. She was discharged home on POD#4. Pathology revealed a 1.4-cm x 1.3-cm x 0.8-cm right upper lobe moderately-differentiated adenocarcinoma with peripheral bronchioloalveolar pattern, T1aN0M0, stage 1A (negative resection margins) as well as a 4-cm x 3.5-cm x 1.8-cm left lower lobe pedunculated focally cystic pleural SFT containing metastatic breast ductal carcinoma, ER(+)/PR(+)/HER2(-), extending to within 0.5 mm of SFT surface and within vessels of the pseudocapsule (negative resection margins). She was placed on adjuvant fulvestrant and exemestane.DiscussionSFTs have been described as recipients for tumor-to-tumor metastases in only 5 other cases, 4 of which were synchronous with the primary donor tumor. SFTs are firm, smooth, lobulated, spindle-cell masses surrounded by capsules exhibiting rich vascularity, a characteristic shared with renal cell carcinoma, making them more suitable for harboring metastasis.ConclusionsWe present an unusual case of tumor-to-tumor metastasis involving (PET)-negative breast cancer as donor to a recipient SFT 6 years after treatment for primary breast cancer and synchronous with contralateral primary lung cancer.Reference #1: Petraki et al, International Journal of Surgical Pathology 11(2):127-135, 2003DISCLOSURE: Eric Toloza: Other: Honoraria from Intuitive Surgical Inc. for proctoring & observation site The following authors have nothing to disclose: Frank Velez-Cubian, Robert Gabordi, Prudence Smith, Shohreh Dickinson, Carla Moodie, Joseph GarrettNo Product/Research Disclosure Information.

25 keywords...

hide…