Case Report

Collision Tumor: Invasive Ductal Carcinoma in Association with Mucosa-associated Lymphoid Tissue (MALT) Lymphoma in the Same Breast

Authors: Joanne M. Quilon, MD, Thomas A. Gaskin, MD, Arthur S. Ludwig, MD, Catherine Alley


Synchronous occurrence of multiple neoplastic processes is uncommon and the relationship between breast cancer with lymphoproliferative diseases is unusual as well. Furthermore, breast involvement by malignant lymphoma is a rare event and primary breast mucosa-associated lymphoid tissue (MALT) lymphoma is even rarer. We report a patient with synchronous occurrence of malignant lymphoma of MALT type and ductal carcinoma of the breast, presenting as “collision tumor,” invading each other and occurring as a single mass in the breast. Involvement of the sentinel lymph node by MALT lymphoma was demonstrated with no evidence of metastatic carcinoma. Staging bone marrow biopsy did not show involvement by malignant lymphoma or carcinoma. Our patient was treated with chemotherapy for the lymphoma. She also received radiotherapy and aromatase inhibitor as adjuvant therapy for the breast carcinoma.

Key Points

* The relationship between breast cancer and lymphoproliferative disease is unusual with an association rate of 1.5%.

* Primary breast lymphomas are uncommon and represent 0.04% to 0.52% of all breast malignant neoplasms.

* The incidence of MALT lymphomas among the breast lymphoma cases ranges from 8.5 to 35%.

* Among other factors implicated in the occurrence of synchronous breast carcinomas and lymphoma, mouse mammary tumor virus (MMTV) has recently been suggested to be a common etiologic agent of the two neoplasms.

* It is important to keep an open mind to the possibility of multiple primary neoplasms in patients with carcinoma.

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