ABSTRACT Metastatic breast carcinoma has been described at nu- merous sites in the head and neck region. Here, we re- port a case of a 56 year old female patient with invasive ductal carcinoma metastasizing to the nasopharynx. The patient presented initially with liver metastasis fol- lowed by metastasis to the nasopharynx. This is the se- cond documented and first proved case of metastatic breast carcinoma to the nasopharynx. Key words: Breast carcinoma, nasopharynx, immuno- histochemistry ÖZET Metastatik meme karsinomu bafl ve boyun bölgesinde birçok yerde tan›mlanm›flt›r. Bu makalede nazofarink- se metastaz yapan meme invaziv duktal karsinomlu 56 yafl›ndaki kad›n hasta olgusu sunulmufltur. Olguda bafl- lang›çtaki karaci¤er metastaz›n› takiben nazofarinks metastaz› izlenmifltir. Nazofarinkste metastatik karsi- nom son derece nadirdir. Bu olgu, meme karsinomunun ikinci belgelenmifl ve ilk kan›tlanm›fl nazofarinks metas- taz›d›r. Anahtar sözcükler: Meme karsinomu, nazofarinks, immünhistokimya INTRODUCTION Most tumors arising in the nasopharynx are either squamous cell carcinomas or so-called undifferentiated carcinomas of the nasophary- ngeal type. Metastatic tumors to this region are rare, but cases metastatic to the nasopharynx from pulmonary and renal primaries have been reported in the literature (1). In the present case, an invasive breast ductal carcinoma metastasi- zing to the nasopharynx was noted. CASE REPORT A 56 year old woman presented in July 2003, with palpable mass in the upper inner qu- adrant of her right breast. A right modified radi- cal mastectomy and an axillary node dissection were performed. The tumor was 4.5 cm in its largest diameter. The pathological diagnosis was invasive ductal carcinoma with 12 of 18 axillary nodes involved (pT2pN1). Immunohis- tochemical stains at that time indicated that tu- mor cells were negative for estrogen (ER) and progesterone (PR) receptors and Herceptest was 1(+). Postoperatively, the patient received six courses of chemotherapy. At the completion of chemotherapy, she underwent radiotherapy. In November 2004, Her2/neu gene amplification was detected by fluorescence in situ hybridizati- on (FISH) technique. The patient received we- ekly Herceptin with an initial 4 mg/kg dose and subsequent 2-mg/kg doses. In February 2005, she developed liver nodules as evidenced by fol- low-up computed tomography (CT) consistent with metastatic disease. A subsequent bone scan showed no bone metastases. In March 2005, CT scans of the brain and temporal bone were unre- markable. Head and neck examination revealed Breast carcinoma metastatic to nasopharynx Nazofarinkse metastaz yapm›fl meme karsinomu fiirin BAfiPINAR 1 , Nilgün KAPUCUO/LU 2 , Nermin KARAHAN 2 , Hasan YASAN 3 , Hasan fienol COfiKUN 4 , Özden ÇANDIR 2 Department of Pathology, Egirdir Bone Joint Diseases Treatment and Rehabilitation Hospital 1 , Department of Pathology, Suleyman Demirel University School of Medicine 2 , Department of Ear, Nose and Throat, Suleyman Demirel University School of Medicine 3 , Department of Oncology, Suleyman Demirel University School of Medicine 4 , ISPARTA Corresponding Author: Sirin Baspinar, MD, E¤ridir Kemik Ek- lem Hastal›klar› Tedavi ve Rehabilitasyon Hastanesi Patoloji Labo- ratuvar› E¤irdir-Isparta 196 Turkish Journal of Pathology 2006;22(3):196-199