1.Synchronous Metastatic Breast Carcinoma involving an Endometrial Polyp and Uterine Leiomyomas: A Case Report
Sarah Lizette Aquino-Cafino ; Jose Vicente G. Borja ; Al-Zamzam A. Abubakar
Philippine Journal of Pathology 2026;(75th PSP Research Competition Abstracts):1-
Introduction:
Breast carcinoma commonly metastasizes to the lymph nodes, bones,
lungs, liver, and brain, and synchronous metastatic involvement of both endometrial
polyp and uterine leiomyomas are exceedingly rare occurrence.
Case description:
A 48-year-old female patient presented with a chief complaint of
abnormal uterine bleeding and underwent total hysterectomy. Gross examination of
the specimen showed a 6.0 cm pedunculated mass at the posterior endometrium with
multiple well-defined, tan-white mass with whorl-like pattern, grossly consistent with
endometrial polyp and leiomyomas, respectively. Microscopic sections of both the polyp
and leiomyomas demonstrated tumor cells arranged in nests and solid sheets consisting
of moderately pleomorphic tumor cells with irregularly round to oval, hyperchromatic
to open vesicular chromatin, inconspicuous to visible nucleoli and abundant eosinophilic
cytoplasm – features reminiscent of invasive carcinoma of the breast. Review of the
patient’s past medical history revealed a diagnosis of breast cancer made three months
prior to the onset of gynecologic symptoms.
Discussion:
Immunohistochemistry studies for Mammaglobin, GATA3 and PAX8 were
performed which demonstrated positive staining for Mammaglobin and GATA3. PAX8
negativity excluded a primary gynecologic origin. In the context of the patient’s prior
diagnosis of breast carcinoma, along with morphologic features and immunoprofile,
this case was signed-out as metastatic breast carcinoma involving an endometrial polyp
and uterine leiomyomas.
Conclusion
Endometrial polyp and uterine leiomyomas are two of the most common
benign neoplasms in the gynecologic tract. Metastatic involvement of these lesions is
exceedingly rare; to the best of our knowledge, there are only 15 reported cases of
endometrial polyp and 24 leiomyoma metastases. Despite its rarity, both clinicians
and pathologists alike must be aware of this entity to ensure accurate diagnosis and
appropriate management.

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