Bilateral breast metastasis as the first sign of recurrence of a cutaneous melanoma: A case report

Abstract

Breast skin and parenchyma are metastatic sites for various tumours. Metastasis to the breast is rare, but it must be considered in the differential diagnosis of a breast mass. Melanoma is among the most commonly reported metastatic tumours of the breast. With the increasing incidence of melanoma, this complication is being encountered with greater frequency. Melanoma has different manifestations in the breast. All these manifestations are important not only as initial presentations of the disease, but also as indicators of the progression period of the disease. Along with a brief review of the literature, we report the case of a woman who presented with breast metastasis after 17 years as the first sign of recurrence of a melanoma. The aim of this study was to report the clinico-pathological features of a patient with metastatic melanoma to the breast. Metastasis can mimic either benign disease or primary malignancy and is often an unexpected diagnosis in a patient presenting with a breast mass. These masses generally indicate disseminated disease with very short survival. Metastasis should be suspected in patients with a breast mass and a prior history of melanoma even if the primary was removed a long time ago (17 years in our case). Fine needle aspiration cytology combined with immunohistochemistry is essential for the diagnosis of metastasis.

Immunohistochemistry Applied to Breast Cytological Material

“…Malignant melanomas may be identified by their typical morphology or the presence of melanin pigment. In case these are insufficient, however, S100, HMB-45, and Melan-A have all been successfully used to confirm histogenesis in a variety of publications [45, 59-61, 67, 74-76].…”