Rare Axillary Cancer of Unknown Primary Originating from the Breast in Male Patient with PALB2 Pathogenic Variants: A Case Report
Cancer of Unknown Primary
Keywords:
Cancer of unknown primary, (PALB2) pathogenic variants, Male breast cancerAbstract
Abstract
Background: Cancer of unknown primary (CUP) accounts for less than 5% of all cancers. Male breast cancer is a rare disease. The occurrence of bilateral breast involvement is even rarer, at approximately 0.5-2.5%. Genetic factors contribute to about 5-10%, with partner and localizer of BRCA2(PALB2) gene mutations accounting for 1-2%.
Case Report: We found a male with breast cancer who initially presented with metastatic adenocarcinoma at the axillary lymph node of unknown primary origin. After axillary lymph node dissection (ALND) with radiation therapy (RT), adjuvant chemotherapy, and regular surveillance, recurrence was observed on the same other side as the axillary lymph node. The PALB2 gene abnormality was also identified. Finally, he underwent prophylactic bilateral mastectomy, and the pathology report included bilateral benign breast tissue.
Conclusion: Patients without Breast cancer gene (BRCA)mutations should be offered next-generation sequencing (NGS) multi-gene panel testing to detect other abnormalities when personal is suggestive of a hereditary syndrome. The roles of bilateral prophylactic mastectomy, ALND, and RT will be discussed with the patient.
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