Cutaneous metastasis as the first manifestation of occult malignant breast neoplasia

Weimann, Ellem Tatiani de Souza; Botero, Erica Bruder; Mendes, Cínthia; Santos, Marcel Alex Soares dos; Stelini, Rafael Fantelli; Zelenika, Caroline Romanelli T. A.

doi:10.1590/abd1806-4841.20164572

Cited by 16 publications

(20 citation statements)

References 6 publications

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“…Typical OBC cases are women who have adenocarcinoma or poorly differentiated carcinoma in the axillary lymph nodes and who have no evident primary breast lesion. Although less common, other metastatic sites have been reported in several case reports [2][3][4][5][6]. Disseminated carcinomatosis of the bone marrow (DCBM) is diffuse infiltration of the bone marrow by malignant cells.…”

Section: Introductionmentioning

confidence: 99%

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

et al. 2020

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Patients with cancer of unknown primary (CUP) are generally treated with chemotherapy. Bone marrow involvement suggests an advanced stage, and CUP with disseminated carcinomatosis of the bone marrow (DCBM) appears to have a dismal prognosis. However, our case of CUP with DCBM was successfully treated with a sequence of endocrine therapy over a long period. A woman presenting with low back pain was found to have multiple bone metastasis without an identifiable primary tumor on imaging studies. Blood tests revealed anemia and thrombocytopenia. A bone marrow biopsy was performed and showed relatively uniform small cells, strongly positive for estrogen receptor and progesterone receptor expression. We considered chemotherapy to be risky due to bicytopenia and an aromatase inhibitor, letrozole, was initiated. The patient's symptoms and laboratory findings gradually improved and bone lesions almost disappeared on FDG-PET/CT after 1 year of treatment. After 2 years on letrozole, hemoglobin levels and platelet counts had been gradually decreasing. Although she had no symptoms and no significant changes were observed on a CT scan, disease progression was highly likely. Thus, second-line treatment with fulvestrant and palbociclib was commenced, and hemoglobin levels and platelet counts were restored to within the normal ranges. She currently continues to receive fulvestrant and palbociclib over a year later. CUP complicated with DCBM might be metastatic occult breast cancer, and endocrine therapy can be a valuable treatment option if tumors express hormone receptors.

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Section: Introductionmentioning

confidence: 99%

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

et al. 2020

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“…Although the biomolecular basis of metastasis is complex and poorly understood, there are 3 basic patterns of metastatic mechanisms reported: (1) stasis: anatomical proximity and lymphatic drainage; (2) organ-specific factors: selective affinity of tumor cells to a specific organ; and (3) nonselective factors: independent of mechanical and organ-specific factors [5]. Metastases affecting the nail apparatus, also called acral or subungual metastases, are extremely rare.…”

Section: Discussionmentioning

confidence: 99%

Subungual Metastasis of an Adenocarcinoma of the Prostate in a Finger

García-Galaviz

Domínguez‐Cherit

Caro-Sánchez

et al. 2018

Skin Appendage Disord

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Cutaneous metastasis is a rare event occurring most frequently in patients previously diagnosed with cancer. However, subungual metastases are even less frequent. The most common neoplasms associated with the latter are lung, kidney, and breast neoplasms. Lung cancer is the main cause of subungual metastases in the fingers, and genitourinary tract tumors are the main cause of subungual metastases in the toes. This is the first case report of an adenocarcinoma of the prostate with subungual metastasis.

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“…In addition to skin adnexal adenocarcinoma, other primary sites should also be considered in the differential diagnosis. Besides breast carcinoma, other malignant neoplasms that metastasize to the skin include lung, ovarian, and colon cancer, as well as melanoma and sarcoma [ 11 ]. A limited panel of IHC stains should be performed to rule out other sites, taking into consideration the patient's clinical history and tumor morphology.…”

Section: Discussionmentioning

confidence: 99%

Occult Breast Carcinoma Presenting as Scalp Metastasis

et al. 2017

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Breast cancer is the most common tumor among women, and approximately 6% of the patients have de novo metastatic breast cancer. Occult breast cancer accounts for only 0.1–0.8% of the cases and most commonly presents with axillary lymphadenopathy. Scalp metastases are rare and have been described as a sign of progression or widespread metastatic disease. Here, we describe a rare case of de novo metastatic breast cancer to the scalp as the single site of spread and without an identifiable primary breast tumor.

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Cutaneous metastasis as the first manifestation of occult malignant breast neoplasia

Cited by 16 publications

References 6 publications

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

Subungual Metastasis of an Adenocarcinoma of the Prostate in a Finger

Occult Breast Carcinoma Presenting as Scalp Metastasis

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