Volume 18, Issue 2 (Iranian Journal of Breast Diseases 2025)
ijbd 2025, 18(2): 162-172 |
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Ethics code: IR.ACECR.IBCRC.REC.1404.007
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Najar Najafi S, Najar Najafi N, Olfatbakhsh A, Hashemi H. Letrozole-Induced Sarcoid-Like Reaction Following Adjuvant Hormonal Therapy in Breast Cancer: A Case Report. ijbd 2025; 18 (2) :162-172
URL: http://ijbd.ir/article-1-1189-en.html
URL: http://ijbd.ir/article-1-1189-en.html
1- Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran , safa3n@gmail.com
2- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
3- Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran
2- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
3- Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran
Abstract: (54 Views)
Introduction: Sarcoid-like reactions (SLRs) are rare, non-caseating granulomatous responses that may mimic metastatic disease in cancer patients. Although drug-induced SLRs are increasingly recognized, they remain underreported in patients receiving endocrine therapy for breast cancer.
Case Presentation: A 49-year-old postmenopausal woman with hormone receptor-positive, HER2-positive invasive ductal carcinoma of the breast was treated with surgery, chemotherapy, radiotherapy, trastuzumab, and adjuvant letrozole. After 48 months of endocrine therapy, she presented with elevated CA 15-3 levels and imaging findings of a new pulmonary lesion with mediastinal lymphadenopathy, raising suspicion of recurrence.
Diagnostic Assessment: Core needle biopsy revealed non-caseating granulomas, and PET-CT showed no evidence of malignancy. Special stains excluded infectious etiologies.
Intervention and Outcome: Letrozole was discontinued, and endocrine therapy was switched to Fulvestrant. Over 10 months, both the pulmonary lesion and lymphadenopathy resolved radiologically, and CA 15-3 normalized.
Conclusion: This case highlights a rare instance of letrozole-induced SLR mimicking recurrence during breast cancer follow-up. Misinterpretation of such lesions may lead to unnecessary interventions. Clinicians should consider drug-induced etiologies when new lesions arise in asymptomatic patients on long-term hormonal therapy.
Case Presentation: A 49-year-old postmenopausal woman with hormone receptor-positive, HER2-positive invasive ductal carcinoma of the breast was treated with surgery, chemotherapy, radiotherapy, trastuzumab, and adjuvant letrozole. After 48 months of endocrine therapy, she presented with elevated CA 15-3 levels and imaging findings of a new pulmonary lesion with mediastinal lymphadenopathy, raising suspicion of recurrence.
Diagnostic Assessment: Core needle biopsy revealed non-caseating granulomas, and PET-CT showed no evidence of malignancy. Special stains excluded infectious etiologies.
Intervention and Outcome: Letrozole was discontinued, and endocrine therapy was switched to Fulvestrant. Over 10 months, both the pulmonary lesion and lymphadenopathy resolved radiologically, and CA 15-3 normalized.
Conclusion: This case highlights a rare instance of letrozole-induced SLR mimicking recurrence during breast cancer follow-up. Misinterpretation of such lesions may lead to unnecessary interventions. Clinicians should consider drug-induced etiologies when new lesions arise in asymptomatic patients on long-term hormonal therapy.
Type of Study: case report |
Subject:
Diagnosis, treatment, rehabilitation
Received: 2025/03/26 | Accepted: 2025/06/7 | Published: 2025/07/16
Received: 2025/03/26 | Accepted: 2025/06/7 | Published: 2025/07/16
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