MASSIVE METASTASES FROM A LOBULAR BREAST-CARCINOMA FROM AN UNKNOWN PRIMARY DURING PREGNANCY - A CASE-REPORT

BACKGROUND: Carcinoma of the breast during pregnancy represents 2-5% o f all breast cancers. The frequency and histopathologic spectrum of br east cancer are similar in pregnant and nonpregnant women. Infiltratin g lobular carcinoma is one of the less understood types of breast canc er, and its metastatic pattern seems to be different from that of infi ltrating ductal carcinoma. Breast neoplasms rarely present as cancer f rom an unknown primary site. CASE: A woman in the third trimester of p regnancy developed carcinoma massively metastatic to the bone marrow a nd liver from an unknown primary tumor. At 32 weeks' gestation a healt hy male was delivered by cesarean section. The patient died 12 hours a fter delivery. The autopsy revealed an infiltrating lobular carcinoma, 1.5 cm, of the breast. CONCLUSION: Massive metastases from an occult lobular breast carcinoma in a pregnant woman are very rare. Diffuse me tastatic spread, which often complicates or delays the diagnosis, is a characteristic pattern of infiltrating lobular carcinoma. Cancer from an unknown primary site during pregnancy is an exceptional finding. I f a metastatic adenocarcinoma is diagnosed in a pregnant woman, a brea st primary should be strongly suspected.