{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:45:03Z","timestamp":1792176303403,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Metastasis to the female genital tract from extragenital primaries is uncommon, with breast and gastrointestinal malignancies representing the predominant sources. Uterine involvement accounts for fewer than 10% of genital tract metastases and most frequently occurs in the setting of disseminated disease with concomitant ovarian involvement. Invasive lobular carcinoma (ILC), despite comprising only 5%\u201320% of breast malignancies, accounts for over 80% of breast cancer metastases to the female genital tract, a predilection attributed to loss of E\u2010cadherin expression\u2014facilitating tumor cell detachment and hematogenous dissemination\u2014and its diffuse infiltrative growth pattern. Metastasis to uterine leiomyomas is exceptionally rare, with approximately 30 cases reported to date. The underlying pathophysiologic mechanism is postulated to involve the hormonally enriched microenvironment of leiomyomas, wherein tissue concentrations of estrogen and progesterone receptors significantly exceed those of the surrounding myometrium, thereby conferring preferential tropism for circulating hormone receptor\u2013positive breast carcinoma cells. Supporting this, 92.3% of reported cases were estrogen receptor positive. Concurrent lymphatic and hematogenous dissemination pathways are implicated based on patterns of organ involvement, with isolated uterine metastasis in the absence of ovarian disease favoring hematogenous spread. We report a case of metastatic invasive ductal\/lobular carcinoma (ER+\/PR+\/HER2\u2010) infiltrating a uterine leiomyoma, identified incidentally on histopathologic examination six years after primary treatment, in an asymptomatic African American woman undergoing hysterectomy for pelvic organ prolapse\u2014representing, to our knowledge, the first such case reported in an African American patient. Immunohistochemical profiling confirmed breast origin and receptor concordance with the primary tumor.<\/jats:p>","DOI":"10.1002\/ijgo.71069","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:41:52Z","timestamp":1779370912000},"page":"646-656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterine intra\u2010leiomyoma metastasis originating from primary breast cancer: A rare entity"],"prefix":"10.1002","volume":"175","author":[{"given":"Vanessa","family":"Bartholomew","sequence":"first","affiliation":[{"name":"University of South Carolina School of Medicine Greenville  Greenville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Lopez","sequence":"additional","affiliation":[{"name":"Pathology Associates  Greenville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6109-5344","authenticated-orcid":false,"given":"Christine M. G.","family":"Schammel","sequence":"additional","affiliation":[{"name":"Pathology Associates  Greenville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Michael","family":"Devane","sequence":"additional","affiliation":[{"name":"Department of Radiology Prisma Health Upstate  Greenville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Schammel","sequence":"additional","affiliation":[{"name":"Pathology Associates  Greenville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.6822"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2017.60.5.481"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000031061"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266338"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.70527"},{"key":"e_1_2_9_7_1","unstructured":"American Cancer Society. Accessed December 2 2025.https:\/\/www.cancer.org\/cancer\/types\/breast\u2010cancer\/about\/how\u2010common\u2010is\u2010breast\u2010cancer.html"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2022.05.015"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(16)36252-4"},{"key":"e_1_2_9_10_1","first-page":"229","article-title":"Mammary carcinoma metastasis to uterine myoma","volume":"23","author":"Birdsall CJ","year":"1964","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(71)90789-7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196604)19:4<544::AID-CNCR2820190412>3.0.CO;2-M"},{"issue":"3","key":"e_1_2_9_13_1","first-page":"211","article-title":"Breast carcinoma metastasizing to the uterus","volume":"6","author":"Di Bonito L","year":"1985","journal-title":"Eur J Gynaecol Oncol"},{"issue":"5","key":"e_1_2_9_14_1","first-page":"476","article-title":"Extragenital metastases to uterine leiomyomata. A case report","volume":"37","author":"O'Brien TF","year":"1992","journal-title":"J Reprod Med"},{"issue":"3","key":"e_1_2_9_15_1","first-page":"243","article-title":"Metastasis of breast cancer to a uterine leiomyoma","volume":"22","author":"Afriat R","year":"1993","journal-title":"J Gynecol Obstet Biol Reprod (Paris)"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1993.1282"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.1995.tb01022.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.1998.0434g.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(98)80094-7"},{"issue":"5","key":"e_1_2_9_20_1","first-page":"915","article-title":"Positron emission tomography detection of breast cancer metastasis to the uterus","volume":"99","author":"Charvolin JY","year":"2002","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(02)00152-5"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.2008.02230.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-008-0069-5"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000218367"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2011.06.008"},{"issue":"5","key":"e_1_2_9_26_1","first-page":"560","article-title":"Lobular carcinoma of the breast metastasizing to leiomyoma in a patient under letrozole treatment","volume":"32","author":"I\u015f\u00e7i H","year":"2011","journal-title":"Eur J Gynaecol Oncol"},{"issue":"6","key":"e_1_2_9_27_1","first-page":"652","article-title":"Micro\u2010metastases into the uterine leiomyoma from invasive ductal breast cancer under adjuvant tamoxifen therapy: case report","volume":"33","author":"Dirican A","year":"2012","journal-title":"Eur J Gynaecol Oncol"},{"issue":"3","key":"e_1_2_9_28_1","first-page":"347","article-title":"Metastatic breast cancer to the uterine cervix mimicking a giant cervical leiomyoma","volume":"74","author":"Horikawa M","year":"2012","journal-title":"Nagoya J Med Sci"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2010.11.010"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.08.019"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-014-0511-6"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1101\/mcs.a001628"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18903"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.241397"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21754"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-021-06207-6"},{"key":"e_1_2_9_37_1","unstructured":"Accessed December 2 2025.\u00a0https:\/\/www.wcrf.org\/cancer\u2010trends\/breast\u2010cancer\u2010statistics"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-023-07040-3"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/11782234221090197"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029021"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.602"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1806"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12092535"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-023-01958-6"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.737112"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:50:05Z","timestamp":1792173005000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":44,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/ijgo.71069"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71069","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}