Table 1.
Clinical and pathologic features of the patients with breast carcinoma metastases to the head and neck
| Case | Age at diagnosis of metastasis | Site | Clinical presentation | Clinical suspicion | Histologic type | Interval from primary to metastasis (years) | Other known metastases before HN metastasis |
|---|---|---|---|---|---|---|---|
| 1 | 47 | Bilateral palatine tonsils | Bilateral tonsil FDG uptake on PET scan | Metastatic breast carcinoma | Pagetoid carcinoma | 7.3 | Axillary lymph node |
| 2 | 81 | Paratracheal soft tissue | Hyperparathyroidism; surgically identified paratracheal mass | Parathyroid hyperplasia | Ductal carcinoma | 22 | Bone |
| 3 | 45 | Nasal cavity | Epistaxis | Primary squamous cell carcinoma versus metastasis | Mucinous carcinoma | 6.3 | Axillary lymph node, pancreas, bone, liver and lung |
| 4 | 53 | Mastoid sinus | Headache/hearing loss/loss of taste on ipsilateral tongue | Metastatic breast carcinoma | Ductal carcinoma | 3.2 | Axillary lymph node, bone |
| 5 | 79 | Mastoid sinus | Not available | Not available | Adenocarcinoma* | N/A | N/A |
| 6 | 92 | Skin face | Chin mass | Primary skin cancer | Lobular carcinoma | Primary diagnosis | None |
| 7 | 53 | Skull base | Rising tumor markers | Metastatic breast carcinoma | Mucinous carcinoma | 9 | Axillary lymph node |
| 8 | 48 | Skull base | Right sided facial pain, tingling, numbness | Malignancy versus atypical infection | Carcinoma with lobular features | Primary diagnosis | None |
| 9 | 39 | Oral cavity | Edematous, painful hypertrophic gingiva | Metastatic breast cancer | Ductal carcinoma | 10.8 | Axillary lymph node, liver and bone |
| 10 | 52 | Oral cavity | Edematous and erythematous gingiva and right RMT | Primary head and neck mucosal-based carcinoma | Pagetoid carcinoma | 5.3 | Axillary lymph node |
| 11 | 78 | Oral cavity | Buccal mass | Primary head and neck tumor of minor salivary glands | Lobular carcinoma | 18 | None |
| 12 | 49 | Orbital soft tissue | Orbital soft tissue mass | Not available | Lobular carcinoma | 7.1 | Bone, ovary and pleural fluid |
| 13 | 61 | Orbital soft tissue/ethmoid and maxillary sinus | Nasal airway obstruction and pain/headache/blurry vision | Metastatic breast carcinoma | Ductal carcinoma | 1 | Axillary lymph node |
| 14 | 75 | Orbital soft tissue | Lacrimal sac mass | Not available | Lobular carcinoma | 5 | Bone |
| 15 | 58 | Orbital soft tissue | Lower eyelid mass | Lymphoma versus metastatic carcinoma versus sarcoid | Lobular carcinoma | Primary diagnosis | Possible axillary lymph node by imaging |
| 16 | 80 | Orbital soft tissue | Diplopia | Lymphoma versus inflammatory pseudotumor | Lobular carcinoma | 33 | None |
| 17 | 61 | Neck lymph node | Left supraclavicular LAD | Metastatic breast carcinoma | Lobular carcinoma | 13 | Bone |
| 18 | 52 | Neck lymph node | Left neck LAD | Metastatic breast carcinoma | Ductal carcinoma | 2.1 | Axillary lymph node, lung, liver, chest wall and bone |
| 19 | 55 | Neck lymph node | Left neck level II LAD | Metastatic breast carcinoma | Ductal carcinoma | N/A | N/A |
| 20 | 49 | Neck lymph node | Painful left neck LAD involving brachial plexus | Metastatic breast carcinoma | Ductal carcinoma | 10.3 | Axillary and hilar lymph node, lung and bone |
| 21 | 76 | Neck lymph node | Left neck LAD, hoarse voice | Metastatic carcinoma | Lobular carcinoma | 9 | Axillary lymph node |
| 22 | 61 | Neck lymph node | Not available | Not available | Ductal carcinoma | 7 | Axillary lymph node |
| 23 | 66 | Neck lymph node | Left neck LAD | Metastatic carcinoma versus lymphoma | Ductal carcinoma | 11 | None |
| 24 | 44 | Neck lymph node | Right neck LAD | Metastatic papillary thyroid carcinoma | Ductal carcinoma | 11 | None |
| 25 | 79 | Skull Base/Clivus | Headaches | Chondrosarcoma | Ductal carcinoma | 28 | None |
RMT retromolar trigone, LAD lymphadenopathy, HN head and neck
* Histologic type not further classified due to crush artifact