A Follow-Up Case of Breast Carcinoma with the Unusual Visitor in Peripheral Blood: Unlock Feathered Edge Secret Breast Carcinoma with Unusual Visitor in PBS

Anurag Singh (1), Rashmi Kushwaha (2), Uma Shankar Singh (3), Shailendra Prasad Verma (4)
(1) Department of Pathology, King George Medical University Lucknow, India , India,
(2) Department of Pathology, King George Medical University, Lucknow, India, India,
(3) Department of Pathology, King George Medical University Lucknow, India, India,
(4) Department of Clinical Hematology, King George Medical University, Lucknow, India , India

Abstract

Background: Breast cancer is the most common cancer in women worldwide and in India. There are very few cases of breast cancer with peripheral blood dissemination having acute leukaemia-like blast cells.


Case presentation: Here we present a  44-year-old breast cancer follow-up patient with the presence of leukaemia-like blast cells in peripheral blood. The specific cytochemical staining and immunophenotyping assays on bone marrow biopsy revealed that atypical cells in her peripheral blood were from breast cancer metastasis. A comprehensive workup confirmed carcinocythemia in the present case and systemic chemotherapy and hormonal therapy were planned. However, she died 15 days after the carcinocythemia presentation. Carcinocythemia patients have a poor survival.


Conclusion: Because carcinocythemia cells can mimic leukemic blasts and share morphological features, the patient's medical history and a careful analysis of the feathery border of the smear are needed to make a definitive diagnosis.

Full text article

Generated from XML file

References

Ronen S, Kroft SH, Olteanu H, Hosking PR, Harrington AM. Carcinocythemia: A rare entity becoming more common? A 3-year, single institution series of seven cases and literature review. Int J Lab Hematol. 2019;41(1):69-79. doi:10.1111/ijlh.12924.

Seronie-Vivien S. Carcinocythemia as the single extension of breast cancer: report of a case and review of the literature. Ann Oncol 2001;12:1019–22. doi:10.1023/a:1011184706281.

Friberg S, Nyström A. Cancer Metastases: Early Dissemination and Late Recurrences. Cancer Growth Metastasis. 2015;8:43-49. doi:10.4137/CGM.S31244.

Chang YH, Hsieh RK, Chang MC, Chen GS. Breast cancer with an unusual leukemia-like presentation: case report and literature review. Med Oncol. 2008;25(1):100-103. doi:10.1007/s12032-007-0048-2.

Aboulafia DM. Carcinocythemia. A terminal manifestation of metastatic breast cancer. West J Med. 1992;157(6):672-674.

Agnoletto C, Caruso C, Garofalo C. Heterogeneous Circulating Tumor Cells in Sarcoma: Implication for Clinical Practice. Cancers (Basel). 2021;13(9):2189. doi:10.3390/cancers13092189.

Harouaka R, Kang Z, Zheng SY, Cao L. Circulating tumor cells: advances in isolation and analysis, and challenges for clinical applications. Pharmacol Ther. 2014;141(2):209-221. doi:10.1016/j.pharmthera.2013.10.004.

Valentini CG, Fianchi L, Voso MT, Caira M, Leone G, Pagano L. Incidence of acute myeloid leukemia after breast cancer. Mediterr J Hematol Infect Dis. 2011;3(1):e2011069. doi:10.4084/MJHID.2011.069.

Renella R, Verkooijen HM, Fioretta G. Increased risk of acute myeloid leukaemia after treatment for breast cancer. Breast. 2006;15(5):614–9. doi: 10.1016/j.breast.2005.11.007.

Singh A, Rawat S, Kushwaha R. An Unusual Guest in a Peripheral Blood Smear: Circulating Endothelial Cells as an Artifact or an Incidental Finding?. Journal of Primary Care Specialties.:10-4103. doi: 10.4103/jopcs.jopcs_4_24.

Singh A, Rawat S, Yadav G, Kushwaha R, Verma SP, Singh US. Study of Hemato-morphological Features in Neuroblastoma Infiltrating Marrow. J Lab Physicians. 2022;15(2):224-229. doi:10.1055/s-0042-1758667.

Jauch SF, Riethdorf S, Sprick MR, et al. Sustained prognostic impact of circulating tumor cell status and kinetics upon further progression of metastatic breast cancer. Breast Cancer Res Treat. 2019;173(1):155-165. doi:10.1007/s10549-018-4972-y.

Ronen S, Kroft SH, Olteanu H, Hosking PR, Harrington AM. Carcinocythemia: A rare entity becoming more common? A 3-year, single institution series of seven cases and literature review. Int J Lab Hematol. 2019;41(1):69-79. doi:10.1111/ijlh.12924.

Bai S, Lin S, Lin T. Clinical diagnostic biomarker "circulating tumor cells" in breast cancer - a meta-analysis. Front Oncol. 2023;13:1137519. doi:10.3389/fonc.2023.1137519.

Chang YH, Hsieh RK, Chang MC, Chen GS. Breast cancer with an unusual leukemia-like presentation: case report and literature review. Med Oncol. 2008;25(1):100-103. doi:10.1007/s12032-007-0048-2.

Authors

Anurag Singh
Rashmi Kushwaha
docrashmi27@yahoo.co.in (Primary Contact)
Uma Shankar Singh
Shailendra Prasad Verma
1.
Singh A, Kushwaha R, Singh US, Verma SP. A Follow-Up Case of Breast Carcinoma with the Unusual Visitor in Peripheral Blood: Unlock Feathered Edge Secret: Breast Carcinoma with Unusual Visitor in PBS. Arch Breast Cancer [Internet]. 2024 Jul. 31 [cited 2024 Oct. 3];11(3). Available from: https://www.archbreastcancer.com/index.php/abc/article/view/939

Article Details