Breast Metastasis of a Squamous Cell Carcinoma of the Uterine Cervix Mimicking Inflammatory Breast Cancer

Abstract

Breast metastases from distant carcinoma are infrequent, and cervix carcinoma is rarely the primary lesion. We describe the first case of a cervical squamous cell carcinoma with breast metastasis mimicking an inflammatory breast cancer in a 74-year-old woman. Seventeen months after the treatment of a primary tumor, the patient developed breast lesions looking like an inflammatory breast tumor. After a 1-year delay due to the patient’s refusal, pathological examination and immunohistochemistry confirmed the diagnosis of breast metastasis from a poorly differentiated squamous cell carcinoma. The volume of the breast was huge, associated with axillary lymphadenopathies and multiple lung metastases. Despite platinum-based chemotherapy, the disease progressed and the patient died rapidly, 3 months after the first chemotherapy cycle and 15 months after the first mammary symptoms. We review the literature concerning breast metastases from gynecologic cancers and, particularly, from cervical squamous cell carcinoma. Differential diagnosis of such lesions may be problematic but is essential to avoid unnecessary mutilating surgery and to institute the appropriate systemic therapy. The prognosis is poor.

Breast metastasis of a cutaneous squamous cell carcinoma: case report

“…Several other sites of metastasis, besides the breast, have already been described in the literature as due to the increase in survival time of patients, resulting from the multidisciplinary treatment for primary tumor 6 . Figure 6.…”

“…The primary tumors that spread more often to the breast are, in descending order of frequency: melanoma, lymphoma, lung cancer, soft tissue sarcoma, ovarian carcinoma, gastrointestinal and genitourinary cancers 6 .…”

“…Regarding the immunohistochemical study, no marker is 100% sensitive or specific for any type of tumor 5 . Breast metastases do not normally express estrogen, progesterone and HER2 protein receptors 6 . The combination of cytokeratin 7 and cytokeratin 20 is useful when categorizing carcinomas 12 .…”

“…Secondary breast tumors can occur due to tumors in the contralateral breast or originate in almost any extramammary site 5 . However, breast's metastatic involvement is also very rare, representing from 0.5 to 1.5% of all malignant breast neoplasms in clinical series and 6.6% in autopsies series 6 . The types most frequently associated with breast metastases spots are: skin (melanoma), lung, prostate, intestine (intestinal carcinoid), ovary, stomach, renal cell, thyroid and soft tissue (sarcomas) 5 .…”

The Clinical Significance of Occult Gynecologic Primary Tumours in Metastatic Cancer

“…The clinical and pathologic features of metastatic gynecologic primary tumours (gpts) can mimic metastatic disease from other sites [8][9][10][11] , complicating the task of effectively managing affected patients-for example, by quickly referring them to specialized gynecologic oncology services. Accurate diagnosis of gpt cancers might improve survival by allowing patients to benefit from a growing arsenal of effective site-specific (targeted) therapies 4,12 .…”