Case description
A 36-year-old woman was referred to our center with a painless palpable
mass in the upper central portion of the left breast. She had no family
history of breast cancer and no personal history of other malignancies.
Ultrasonography (US) showed an approximately 3.5x3cm irregularly shaped,
indistinct, hypoechoic mass with multiple ipsilateral enlarged axillary
lymph nodes (Fig. 1A). Preoperative magnetic resonance imaging (MRI)
showed an approximately 3.9x3.5cm irregular mass with heterogeneous
enhancement and multiple enlarged axillary lymph nodes (Fig. 1B). On
MRI, an irregular mass with heterogeneous enhancement was found on the
upper inner quadrant of the right breast, and we recommended MR-guided
US for this lesion (Fig. 2A). On MR-guided US, an approximately 1.4 x
0.4cm irregular-shaped and indistinct mass was detected that correlated
to the MR lesion (Fig. 2B). US-guided core biopsies for both breast
lesions and the left axillary lymph node were performed, and the
pathologic results confirmed invasive ductal carcinoma in the left
breast, suggested MALT lymphoma in the right breast, and confirmed
metastatic adenocarcinoma in the left axillary lymph node. Although the
synchronous occurrence of multiple neoplastic processes is uncommon, the
possibility of synchronous breast carcinoma and primary breast lymphoma
should be considered to avoid inaccurate staging and delays in diagnosis
and to ensure good therapeutic and prognostic implications (1, 2).