HISTORY

FINDING & CONCLUSION

Mammography revealed a irregular solid lesion in the right breast upper quadrant with mild architectural distortion
Mild spiculations also noted
No foci of abnormal microcalcifications noted
Few foci of scattered benign macrocalcifications noted
In drawing of the right nipple noted, suggesting retroareolar extension of the disease
Right axillary nodes noted
Vascular calcifications noted bilaterally
Modeartely dense breast parenchyma bilaterally
No abnormal lesion in the left breast
BI-RADS VI–RIGHT BREAST

Large solid lesion in the right periareolar region extending from 12 to 2 o’ clock, with irregular margin and some internal vascularity
Extension in the retroareolar region also noted
Lesion measures 2.6 x 2.3 x 1.3cm
Small BI-RADS III lesion in left breast noted of 7mm at 10 o’ clock position. Strain value suggest benign nature
Elastography strain values is 5, also suggestive of malignant neoplastic etiology

Heterogeneous liver echotexture with no focal lesions
Large solid lesion in the cervix suspicious for neoplastic etiology
This lesion had moderate vascularity
Enlarged heterogeneous uterus with a focal echogenic bright leiomyoma in the fundus
Ovaries not well seen. Endometrium was normal
Multiple Para-aortic lymphadenopathy was noted. Largest was 2.8cm
No ascites

Large solid lesion in the cervix with moderate vascularity of 3.7 x 2.8cm size
Enlarged bulky heterogenous uterus with focal intramural bright echogenic lipo-leiomyoma in the fundus of 3.2 x 2.5cm size
Ovaries were not well seen
Normal endometrium with indentation from the leiomyoma
Based on these usg findings furthur evaluation with CT abdomen and pelvis was advised
Biopsy of the cervical lesion was also suggested

Slightly bulky uterus showing heterogeneous enhancing mass lesion involving the uterine cervix-likely to be neoplastic
A well-defined lesion in relation to (most likely within) the left side of the uterine fundus with soft tissue and fat could represent a lipoleiomyoma
Multiple enlarged retroperitoneal (from the level of superior mesenteric artery upto the aortic bifurcation), bilateral common & internal iliac and retrocrural lymph nodes

SYNCHRONOUS DUAL PRIMARY MALIGNANCIES–BREAST & CERVIX

Breast and Ovarian synchronous carcinomas are known to occur
The synchronous occurrence of carcinoma of the uterine cervix and the breast is a rarity
No definite link has been established between the two
OCP use increases the incidence of both cancers but not necessarily together
Occurrence of Lipo-Leiomyoma is also rare

SYNCHRONOUS DUAL PRIMARY MALIGNANCIES –BREAST & CERVIX

AGARWAL RASHI. Synchronous dual malignancy: Successfully treated cases. Journal of Cancer Research and Therapeutics, Vol. 3, No. 3, July-September, 2007, pp. 153-156
Verstovsek S et al. Synchronous primary cancers of the breast and cervix: planning multidisciplinary primary treatment [clinico-pathological conference]. Am J Clin Oncol.2000 Feb;23(1):99-103
Sharma DN. Synchronous occurrence of carcinoma of the uterine cervix and of the breast . European Journal of Surgical Oncology Volume 25, Issue 5, Pages547–548, October 1999
Prieto A, Crespo C, Pardo A et-al. Uterine lipoleiomyomas: US and CT findings. Abdom Imaging. 25 (6): 655-7
Tsushima Y, Kita T, Yamamoto K. Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol. 1997;70 (838): 1068-70

September 2014