Estrogen/progesterone/testosterone congeners
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Synchronous breast ductal carcinoma and papillary thyroid carcinoma: case report A 48-year-old woman developed synchronous breast ductal carcinoma and papillary thyroid carcinoma during exogenous hormonal therapy with estrogen, progesterone and unspecified testosterone congener for dysfunctional uterine bleeding and adenomyosis. The woman was admitted in March 2018 with a lump in her left breast. Physical examination revealed a lesion in the upper outer quadrant of the left breast with intermittent bloody discharge from the nipple and some abnormal enlargement in the left axillary lymph nodes. Histology of a biopsy specimen collected from the left nodule showed an estrogen and progesterone receptor-positive invasive ductal breast carcinoma with scirrhous type (cT3NxM0). The Ki-67 labeling index was 60%. Simultaneously, an ultrasound showed hypoechoic nodule of the thyroid. A fine needle aspiration biopsy of the thyroid nodule specimen revealed papillary thyroid carcinoma (cT2NxM0, stage-I). During routine check-up, a transvaginal ultrasound findings were consistent with uterine fibroids. She had been receiving IM injections of estrogen, progesterone and testosterone congener [androgen] for more than 5 years [dosages not stated]. She did not have family history of breast or papillary thyroid cancer. She did not receive radiation therapy to her neck region. Thyroiditis was not detected during preoperative tests. She had undergone endometrial scraping surgery 30 years prior due to underlying adenomyosis and uterine functional bleeding. She was diagnosed with advanced stage luminal-B type breast carcinoma. The woman was treated with four cycles of neoadjuvant chemotherapy comprising cyclophosphamide and epirubicin, followed one cycle of docetaxel resulting in the stable disease. In March 2019, she underwent modified radical mastectomy and resection of thyroid carcinoma (total thyroidectomy and bilateral central group [levels-VI and VII] lymph node dissection). Histopathology of the breast cancer specimen revealed estrogen and progesterone receptors-positive invasive ductal carcinoma with lymph node metastasis (pT3N3aM0, stage-IIIc). The Ki-67 labeling index was 10%. Histopathology of the thyroid specimen revealed papillary thyroid carcinoma with a classical subtype, right central regional lymph node metastasis and no left central regional lymph node metastasis (pT2N1M0, stage-I). After the surgery, she received radiotherapy and completed remaining three cycles of the chemotherapy. Her endocrine therapy was continued. During the 2-year follow-up, she had no postoperative complications and no metastasis. Kong H, et al. Synchronous papillary thyroid carcinoma and breast ductal carcinoma. Journal of International Medical Research 48: No. 8, 1 Aug 2020. Available from: URL: 803503457 http://doi.org/10.1177/0300060520948710
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Reactions 26 Sep 2020 No. 1823
