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| LETTER TO THE EDITOR - DOCUMENTING A CASE |
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| Year : 2011 | Volume
: 7
| Issue : 3 | Page : 387-389 |
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Second primary malignancy of breast in a patient of gastrointestinal stromal tumor presenting as fluoro-deoxyglucose-avid breast incidentaloma in fluoro-deoxyglucose-positron emission tomography
Subhash K Ramani1, Sandip Basu2, Vani Parmar3, Sumeet Gujral4, Sandip Bibte3
1 Department of Radiology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
2 Radiation Medicine Centre, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
3 Department of Surgery, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
4 Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| Date of Web Publication | 2-Nov-2011 |
Correspondence Address:
Sandip Basu
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai - 400 012, Maharashtra
India
DOI: 10.4103/0973-1482.87031 PMID: 22044838
How to cite this article:
Ramani SK, Basu S, Parmar V, Gujral S, Bibte S. Second primary malignancy of breast in a patient of gastrointestinal stromal tumor presenting as fluoro-deoxyglucose-avid breast incidentaloma in fluoro-deoxyglucose-positron emission tomography. J Can Res Ther 2011;7:387-9 |
How to cite this URL:
Ramani SK, Basu S, Parmar V, Gujral S, Bibte S. Second primary malignancy of breast in a patient of gastrointestinal stromal tumor presenting as fluoro-deoxyglucose-avid breast incidentaloma in fluoro-deoxyglucose-positron emission tomography. J Can Res Ther [serial online] 2011 [cited 2013 Jun 18];7:387-9. Available from: http://www.cancerjournal.net/text.asp?2011/7/3/387/87031 |
Sir,
A second primary in the breast in a patient of gastrointestinal stromal tumor (GIST) is described in this report. This was a serendipitous observation on the whole body flouro-deoxy glucose-positron emission tomography (FDG-PET) study. The patient, a 49-year-old female, an operated case of gastric GIST, underwent FDG-PET for a whole body disease survey and did not show any abnormal disease focus except for an intense (SUVmax 4.3) focus in the left breast [Figure 1]. The patient underwent mammography and guided biopsy to correlate this incidentally detected FDG-avid focus in the breast [Figure 2]. The final histopathology turned out to be infiltrating ductal carcinoma grade III [Figure 3], with triple negative breast carcinoma on immunohistochemistry. Several second primaries in the setting of GIST have been reported in the literature. The present association, to the best of our knowledge, is the first report of breast carcinoma in the setting of GIST. | Figure 1: study demonstrating an intense abnormal disease focus (SUVmax = 4.3) in the left breast
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 | Figure 2: (a and b) Mammographic hook wire localization was done for the nonpalpable mass corresponding to the fl ouro-deoxy glucose-avid left breast focus and specimen radiography was performed showing the mass with the hook wire needle
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 | Figure 3: Section shows infi ltrating ductal carcinoma (H and E, ×40). The hormone receptor status was triple negative (ER-/PR-/Her2-) on immunohistochemistry
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Synchronous or metachronous second primaries in the setting of GIST have been reported in the literature including that of the non-GI system. [1],[2],[3],[4],[5] There is a solitary report of the association of carcinoma breast and GIST. [2] With the improved patient survival in GIST, reports of its association with other neoplasms are becoming more common. The present case upholds the value of incidental observation in whole body FDG-PET and the fact that disease may be detected when it is confined to the site of primary. Concurrent two different primary malignancies detected by whole body FDG-PET or PET/CT have been described to be of distinct advantage and the present observation of diagnosing this unsuspected second primary malignancy further substantiates this.
| > References | |  |
| 1. | Basu S, Mohandas KM, Peshwe H, Asopa R, Vyawahare M. FDG-PET and PET/CT in the clinical management of gastrointestinal stromal tumor. Nucl Med Commun 2008;29:1026-39. 
[PUBMED] [FULLTEXT] |
| 2. | Schiavon G, Maki RG, Fornier M. GIST and breast cancer: 3 Case reports and a review of the literature. Curr Cancer Ther Rev 2009;5:100-4.
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| 3. | Basu S, Nair N, Mohandas KM. FDG-avid thyroid incidentaloma in advanced gastrointestinal stromal tumor: Metachronous dual primaries. Indian J Gastroenterol 2007;26:146-7.
[PUBMED] |
| 4. | Lamba M, Verma S, Prokopetz R, Pierscianowski TA, Jabi M, Moyana T. Multiple cutaneous and uterine leiomyomas associated with gastric GIST. J Cutan Med Surg 2005;9:332-5.
[PUBMED] [FULLTEXT] |
| 5. | Zachaus M, Plotner A, Weimann A, Ruf B. Multiple gastrointestinal stromal tumors in neurofibromatosis type 1. Med Klin (Munich) 2007;102:163-7.
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[Figure 1], [Figure 2], [Figure 3]
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