Breast metastases from extramammary malignancies are uncommon. The most common sources are lymphomas/leukemias and melanomas. Some of the less common sources include carcinomas of the lung, ovary, and stomach, and infrequently, carcinoid tumors, hypernephromas, carcinomas of the liver, tonsil, pleura, pancreas, cervix, perineum, endometrium and bladder. Breast metastases from extramammary malignancies have both hematogenous and lymphatic routes. According to their routes, there are common radiological features of metastatic diseases of the breast, but the features are not specific for metastases. Typical ultrasound (US) features of hematogenous metastases include single or multiple, round to oval shaped, well-circumscribed hypoechoic masses without spiculations, calcifications, or architectural distortion; these masses are commonly located superficially in subcutaneous tissue or immediately adjacent to the breast parenchyma that is relatively rich in blood supply. Typical US features of lymphatic breast metastases include diffusely and heterogeneously increased echogenicities in subcutaneous fat and glandular tissue and a thick trabecular pattern with secondary skin thickening, lymphedema, and lymph node enlargement. However, lesions show variable US features in some cases, and differentiation of these lesions from primary breast cancer or from benign lesions is difficult. In this review, we demonstrate various US appearances of breast metastases from extramammary malignancies as typical and atypical features, based on the results of US and other imaging studies performed at our institution. Awareness of the typical and atypical imaging features of these lesions may be helpful to diagnose metastatic lesions of the breast.
Adenocarcinoma/secondary/ultrasonography ; Adolescent ; Adult ; Breast Neoplasms/*secondary/*ultrasonography ; Breast Neoplasms, Male/secondary/ultrasonography ; Carcinoma/secondary/ultrasonography ; Female ; Humans ; Lymphatic Metastasis/ultrasonography ; Lymphoma, Extranodal NK-T-Cell/pathology/ultrasonography ; Lymphoma, Large B-Cell, Diffuse/pathology/ultrasonography ; Male ; Melanoma/secondary ; Middle Aged ; Multiple Myeloma/secondary/ultrasonography ; Neoplastic Cells, Circulating/pathology

OBJECTIVETo investigate the efficacy, indication and complication of radiofrequency ablation (RFA) with cool-tip needle in patients with hepatic malignancies.

METHODS421 patients with hepatic malignancies underwent ultrasound-guided RFA with cool-tip needle under local anaesthesia. The tumor size was from 1.0 to 15 cm in diameter with an average diameter of 4.3 cm.

RESULTSThe complete ablation (CA) rate was 91.4% (382/418) in the patients with a tumor < 3 cm, 78.9% (97/123) in those with a tumor of 3 to 5 cm and 37.6% (35/93) in the patients with a tumor > 5 cm. No patient died or changed to celiotomy during the 1121 times of RFA for 634 lesions in 421 patients. No hemorrhage occurred in any of these patients after the RFA treatment. The complications included abdominal pain in 32.3% (136/421), nausea in 9.0% (38/421), fever in 34.9% (147/421) and biliary leakage in 0.2% (1/421) of the patients.

CONCLUSIONUltrasound-guided percutaneous radiofrequency ablation with cool-tip needle is effective and safe in the treatment of liver tumors.

Abdominal Pain ; etiology ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; secondary ; Catheter Ablation ; adverse effects ; methods ; Female ; Fever ; etiology ; Gastrointestinal Neoplasms ; secondary ; Humans ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Nausea ; etiology ; Ultrasonography, Interventional

Breast cancer is a rare disease in men. We report a case of 53-year-old obese male, with known cryptogenic cirrhosis and hepatocellular carcinoma, presenting a tender mass on left breast. He was diagnosed with invasive intraductal carcinoma, which was consistent with a sporadic lesion. On the basis of previous literatures, obesity can be regarded as a cause for breast cancer even in men. However, there has been inconsistent data about link between liver cirrhosis and male breast cancer, which can be due to heterogenity in the etiology of cirrhosis. Through this case, it can be postulated that the risk for male breast cancer may vary according to the etiology of cirrhosis.
Breast Neoplasms, Male/*etiology/secondary/ultrasonography ; Carcinoma, Hepatocellular/diagnosis/pathology ; Humans ; Immunohistochemistry ; Liver Cirrhosis/complications/*diagnosis/pathology ; Liver Neoplasms/diagnosis/pathology ; Male ; Middle Aged ; Receptors, Estrogen/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo analyze the therapeutic results and prognostic factors of hepatic metastases treated by ultrasound-guided percutaneous microwave coagulation.

METHODSSeventy-four patients with 149 nodules of hepatic metastases were given percutaneous microwave coagulation therapy. The longest diameter of the metastatic nodule ranged from 0.7 - 6.8 cm (mean, 3.1 +/- 1.8 cm). The cumulative survival rate was analyzed by Kaplan-Meier method and the difference between groups was compared with log-rank test. Cox proportional hazard model was used to determine potential prognostic variables.

RESULTSThe follow-up period for the 74 patients was 5 - 83 months (mean, 25.1 +/- 11.4 months). The overall 1-, 3-, and 5-year cumulative survival rates were 91.4%, 46.4% and 29.0%, respectively. The log-rank test showed that number of metastases, tumor size, tumor cell differentiation and local recurrence or new metastases were statistically significant prognostic factors; while age, sex and site of primary tumors were not significant prognostic factors. Multivariate analysis revealed that tumor differentiation, number of metastases and recurrence or new metastases were statistically significant prognostic factors.

CONCLUSIONUltrasound-guided percutaneous microwave coagulation therapy for hepatic metastases in patients with single metastasis, well-differentiated tumor, and without recurrence and new metastases could achieve long-term survival.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; pathology ; Colorectal Neoplasms ; pathology ; Electrocoagulation ; methods ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnostic imaging ; secondary ; surgery ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Stomach Neoplasms ; pathology ; Survival Rate ; Ultrasonography