Occult breast cancer presenting as a mediastinal mass: case report and review of the literature

Occult breast cancer (OBC) is an uncommon diagnosis in clinical practice, mostly presenting with palpable, ipsilateral axillary lymph node metastases. Occasionally, the initial finding is that of distant metastatic disease, with no evidence of a primary breast lesion on clinical examination or other radiographic study. Subsequent pathologic evaluation of the secondary metastatic site will confirm the origin as a primary breast cancer. Here, the authors report a middle-aged woman diagnosed with an OBC that presented with a mediastinal mass. This was later confirmed to represent metastatic breast cancer, with the patient receiving combination chemotherapy and herceptinbased therapy. Breast MRI at 14 months follow-up was unremarkable, supporting the diagnosis of OBC.

Breast cancer; Occult breast cancer; Unknown primary lesion; Metastasis; Metastatic breast cancer.

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