Breast cancer masculine: Case report and Literature review.

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1 Interntionl Journl of Advnced Multidisciplinry Reserch ISSN: DOI: /ijmr Volume 5, Issue Cse Report DOI: Brest cncer msculine: Cse report nd Literture review. Perl L. Mrtínez Plcios 1*, M del Cármen Cden Villel 2, Cludi Meixueiro Clderon 3. 1 Rdiology Resident t the Posgrdute School of Nvl Snity (ESPOSNAV), Universidd Nvl nd the Hospitl Generl Nvl de Alt Especilidd, Secretrí de Mrin Armd de México (SEMAR). 2 Rdiologist, Rdiology Service of the Nvl Generl Hospitl of High Specilty (HOSGENAES),Coyocn Delegtion, Mexico. 3 Pthologist, Pthology Service, Generl Hospitl of the High Nvl (HOSGENAES), Coyocn Delegtion, Mexico. *Correspondence: Dr. Perl Lilin Mrtínez Plcios. E-mil: dr.perl_mtz@hotmil.com/dr.perl.mtz.p@gmil.com Astrct Keywords cncer, mle rest, rdiologicl dignosis. Brest cncer in men hs shown n increse in its incidence in recent yers, represents up to 1% of cncers in mles, nd less thn 0.1% of cncer deths in this genre. The prevlence shows rise t the end of the sixth nd eginning of the seventh decde of life. Our ojective ws to present cse report of mle rest cncer in ptient of 51 yers of ge, with no personl or fmily history of cncer, in which dvnced invsive ductl crcinom ws dignosed nd review of the literture, the chrcteristics clinicl nd rdiologicl dignostics. Introduction Brest cncer in men (CMB) is rre, equivlent to less thn 1% of cncers in men nd only 1% of ll rest cncers. The incidence of CMB hs incresed during the lst three decdes. (1) Brest cncer in men compred with rest cncer in women occurs lter in life, with higher stge, lower grde nd more positivity for the estrogen / progesterone receptor (ER / PR). (2,3) Risk fctors include 26% fmily history of rest or ovrin cncer, 29% hve personl history of cncer other thn rest cncer nd 14.5% re positive for BRCA1/2 muttions. (4,5) Most cses of CBM re ER nd PR positive (90.8% nd 83%, respectively), HER2 nd Ki67 / MIB1 negtive (84.2% nd 61.7%, respectively) nd hve n intermedite / moderte tumor grde (G2) (52.4 %). (6) Ft consumption nd oesity (7-9) hs een ssocited with certin cncers, including colorectl, rest nd prostte cncers. (7) Exposure to electromgnetic fields hs een postulted to contriute to the risk of mle rest cncer, lthough the dt re inconclusive. (10,11) 68

2 Cse Report Ptient of 51 yers of ge, of mechnicl occuption, who went to the emergency room in Decemer of 2017, with clinicl picture of 1 month of occsionl mild dyspne, pin in the right shoulder nd ck pin; Itching in the right reol complex of 10 yers of evolution which in the lst month ulcerted. Physicl exmintion reveled perireolr tumor in the right rest with ulcertion of the nipple reol complex, for which n pproch ws mde for rest cncer. In Jnury 2018, mmmry ultrsound nd mmmogrphy were performed, identifying right retroreolr nodule with mlignnt ppernce, suspicious xillry denopthies, which, ccording to the Americn College of Rdiology, ws clssified s BIRADS 5 (Figure 1). so iopsy of t henodule nd xillry gnglion is performed. The histopthologicl study reports n invsive ductl crcinom ER nd PR positive, Her2Neu negtive, Ki-67: 80% (Figure 2). c FIGURE 1. Mmmogrphy ) ) mid-lterl olique nd cephlocudl projection, retrommry, irregulr nodule with drkened mrgin nd hyperdenseis oserved in the right rest. US fetures c) Irregulr nodule, prllel orienttion, uncircumscried mrgin, undefined, posterior coustic findings with mixed pttern, vsculr to the ppliction of color Doppler. 69

3 c FIGURE 2. Histopthologicl study with immunohistochemistry reports. ) Histologicl cut. Hemtoxylin eosin 200x.Positive estrogen receptors.) PR positive, c y d) Her2-neu negtive, Ki-67 80%respectively. d A simple computed tomogrphy of the chest ws requested in which lytic lesions were oserved in the xil skeleton (spinl column, posterior costl rches nd sternlmnurium), s well s pulmonry nodules, hilr nd medistinl denopthies comptile with metstsis. (Figure 3). Whole-ody PET / CT with 18 FDG is requested for stging, in which xillry, medistinl, retropncretic, gstroheptic denopthies, xil skeletllytic lesions, ilterl pulmonry nodules re reported, ll ssocited with norml hypermetolism in reltion to secondry deposits of the known primry, EC IV metsttic rest cncer is dignosed nd sent to pllitive chemotherpy. FIGURE 3. ) Computedtomogrphy of the thorx with window for one in which lithic lesions re oserved in multiple verterl odies of the thorcicspine. White rrows. ). Computedtomogrphy of the thorx with window for the lung in which ilterl pulmonry nodules re oserved, of dispersed distriution nd in vrile size. Blck rrows. 70

4 Within the extension studies, tumor mrkers C 15.3 with report of 151 U / ml (28/02/2018), C 15.3 with report of 121 U / ml (03/14/2018) nd 70 U / ml ( 03/28/2018). He is currently on chemotherpy tretment with Plocicli plus Letrozoleregimen, 2 cycles, nd externl rdiotherpy to pelvis 30 Gy in 10 frctions (5/10) ws indicted. Discussion In our cse, the ge of presenttion ws 51 yers, in the literture were portn verge ge of 60 yers with vrile rnge etween 50 nd 93 yers (1). The incidence, s in the femle gender, increses with ge nd corresponds to less thn 1% of mle cncers, however, themortlityrteis similr to tht of rest cncer in women, with lower survivl t 5 yers ecuse the dignosis is mde in more dvnced stges of the disese. Cliniclly etween 80 nd 85% deut s mss with progressive growth in the rest, not oserved in our ptient; These condmost frequent clinicl finding is xillry denomegly (up to 42%), oserved in our ptient. Ulcertion of the skin is the third most frequent clinicl feture, up to 14% 2, this eing the predominnt clinicl mnifesttion of our ptient. The predisposing fctors re estrogenic hyperstimultion either endogenous or exogenous, fmily history of the first degree with mlignnt mmmry pthology, genetic fctors such s the BCRA2 muttion present in 4 to 16% of the hereditry CMB (4-6), chromosoml normlities such s Klinefelter syndrome (47 XXY kryotype), lcohol consumption, repetitive rdiologicl exposure efore 20 yers of ge, workers exposed to high tempertures (therml testiculr dmge nd known crcinogens), oese ptients. (8,9) Conclusion Brest cncer in men in rre entity, which usully goes unnoticed y society, due to the smll reported cses, there re no lrge studies ville to know the chrcteristics of this disese, so the current mngement is sed on the extrpoltion of wht is known out rest cncer in women, why we consider it importnt, this is the cse. Declrtions Funding: No funding sources Conflict of interest: None declred 71 References 1. Miguel Ángel Cno, José Alfredo Szelezsn, Ctherine Alvrdo. Crcinom infiltrnte mixto de mm en homres, presentción de dos csos. Rev.Medic.Snits 18 (3): , Korde LA, Zujewski JA, Kmin L, Giordno S, Domchek S, Anderson WF, Brtlett JM, Gelmon K, Nhleh Z, Bergh J, Cutuli B, Pruneri G, McCskill-Stevens W, y col. Reunión multidisciplinri sore el cáncer de mm msculino: resumen y recomendciones de investigción. J ClinOncol. 2010; 28 : [ A rtículo grtuito de PMC ] [ PuMed ] 3. Brinton LA, Cook MB, McCormck V, Johnson KC, Olsson H, Csgrnde JT, Cooke R, Flk RT, Gpstur SM, Gudet MM, Gzino JM, Gkioks G, Guénel P, et l. Grupo de estudio de cáncer rrs europeo Fctores de riesgo ntropométricos y hormonles pr el cáncer de mm msculino: resultdos del proyecto de grupción de cáncer de mm msculino. J NtlCncer Inst. 2014; 106 : djt Errt en: J NtlCncer Inst. 2014; 106: dju117. [ Artículo grtuito de PMC ] [ PuMed ] 4. FJ Couch, LM Frid, ML DeShno, etl: BRCA2 germline muttions in mle rest cncer cses nd rest cncer fmilies Nt Genet 13: ,1996 Crossref, Medline, Google Scholr 5. R Wooster, G Bignell, J Lncster, et l: Identifiction of the rest cncer susceptiility gene BRCA2 Nture 378: ,1995 Crossref, Medline, Google Scholr 6. Rizzolo P, Silvestri V, Vlentini V, Zelli V, Znn I, Msl G, Binchi S, Plli D, Ottini L. Gene-specific methyltion profiles in BRCA muttion positive nd BRCA muttion negtive mle rest cncers. Oncotrget Apr 13;9(28): doi: / oncotrget ecollection 2018 Apr Prk MK, Li WQ, Qureshi AA, ChoE.Cncer Epidemiol BiomrkersPrev Apr 10. pii: cep doi: / EPI [Epuhed of print] Ftintke nd risk of skin cncer in US dults. 8. AW Hsing, JK McLughlin, P Cocco, etl: Risk fctors for mle rest cncer (UnitedSttes) Cncer Cuses Control 9: ,1998 Crossref, Medline, Google Scholr

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