Solitary Cavitary Pulmonary Metastasis from Hormone Receptor-Positive Breast Cancer: A Rare Radiologic Presentation Cavitary Breast Metastasis
Abstract
Background: Pulmonary metastases from breast carcinoma typically present as multiple solid nodules or diffuse lung involvement. Cavitary pulmonary metastases are uncommon, especially when appearing as a solitary lesion, and may closely resemble infectious or primary cavitary lung diseases. These atypical radiologic presentations pose significant diagnostic challenges and can delay appropriate treatment.
Case Presentation: We report the case of a 49‑year‑old woman with a history of right breast invasive ductal carcinoma diagnosed about nine years prior. Her tumor was estrogen receptor‑positive, progesterone receptor‑positive, and HER2‑negative. Initial treatment included lumpectomy, chemoradiotherapy, and endocrine therapy with tamoxifen. She presented with a persistent cough, and chest CT revealed a solitary thick‑walled cavitary lesion in the right lower lung lobe. Bronchoscopy showed no endobronchial abnormalities, and bronchoalveolar lavage was negative for both malignancy and infection. Due to ongoing suspicion, a CT‑guided transthoracic biopsy was performed, confirming metastatic carcinoma consistent with breast primary. This case highlights a rare instance of solitary cavitary pulmonary metastasis occurring several years after initial treatment.
Conclusion: Solitary cavitary pulmonary metastasis from hormone receptor‑positive breast carcinoma is an exceptionally rare phenomenon that can mimic infectious or primary lung malignancies. Persistent cavitary lung lesions in patients with a prior history of breast cancer warrant thorough evaluation and tissue diagnosis, even after extended disease‑free periods.
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Authors
Copyright (c) 2026 Sara Soltanmohammadi, Hesam Amini, Sarvenaz Mirzakhani, Mohammad Reza Ghasri, Mehrshad Abbasi
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