• 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

• Patient underwent TRU_CUT core biopsy of breast and cervical lesion
• Breast – Invasive ductal carcinoma grade II
• Carvix – Adenocarcinoma

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