Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report

Kamaraju, Sailaja; Depke, Jill; Povletich, Janice; Currey, Adam; Weil, Elizabeth

doi:10.1159/000452145

Cited by 6 publications

(9 citation statements)

References 22 publications

(27 reference statements)

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“…Therefore, treatment is primarily targeted towards local control with a multidisciplinary approach. While surgical resection and radiation therapy offer local control, antineoplastic therapy controls systemic disease [7]. However, in cases of diffuse skin involvement (as in our case), mainstream treatment would be chemotherapy, and surgery is the least resorted option.…”

Section: Discussionmentioning

confidence: 90%

A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy

Vemulakonda¹,

Gaur²,

Shaikh³

et al. 2021

Cureus

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Carcinoma breast is the second most common malignancy in females. Due to the recent awareness and medical advances, most of the cases are diagnosed and treated at an early stage. Cutaneous recurrence without other distant metastasis post-surgery in carcinoma breast is usually uncommon. We report a 52year-old lady who presented to us with cutaneous recurrence of carcinoma right breast, post neoadjuvant chemotherapy and modified radical mastectomy. The diagnosis was confirmed on histopathology after the biopsy from the cutaneous nodule. The patient was discussed in the tumor board and planned for palliative chemotherapy considering extensive cutaneous metastasis.

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Section: Discussionmentioning

confidence: 90%

A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy

Vemulakonda¹,

Gaur²,

Shaikh³

et al. 2021

Cureus

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“…Breast cancer cutaneous metastases are incurable and the treatment is directed towards local control with surgical excision, radiation, and chemotherapy 48 . Therefore, considering that the mean human epidermal thickness ranges from 56.6 to 81.5 μm 49 , patients at early stages of the disease, without epidermal invasion, could benefit from PTN-PDT topical treatment in combination with other established therapies.…”

Section: Discussionmentioning

confidence: 99%

Photosensitization of a subcutaneous tumour by the natural anthraquinone parietin and blue light

Mugas

Calvo

Marioni

et al. 2021

Sci Rep

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Photodynamic therapy (PDT) is an anticancer treatment involving administration of a tumour-localizing photosensitizer, followed by activation by light of a suitable wavelength. In previous work, we showed that the natural anthraquinone (AQ) Parietin (PTN), was a promising photosensitizer for photodynamic therapy of leukemic cells in vitro. The present work aimed to analyze the photosensitizing ability of PTN in the mammary carcinoma LM2 cells in vitro and in vivo in a model of subcutaneously implanted tumours. Photodynamic therapy mediated by parietin (PTN-PDT) (PTN 30 µM, 1 h and 1.78 J/cm2 of blue light) impaired cell growth and migration of LM2 cells in vitro. PTN per se induced a significant decrease in cell migration, and it was even more marked after illumination (migration index was 0.65 for PTN and 0.30 for PTN-PDT, *p < 0.0001, ANOVA test followed by Tukey’s multiple comparisons test), suggesting that both PTN and PTN-PDT would be potential inhibitors of metastasis. Fluorescence microscopy observation indicated cytoplasmic localization of the AQ and no fluorescence at all was recorded in the nuclei. When PTN (1.96 mg) dissolved in dimethyl sulfoxide was topically applied on the skin of mice subcutaneously implanted with LM2 cells, PTN orange fluorescence was strongly noticed in the stratum corneum and also in the inner layers of the tumour up to approximately 5 mm. After illumination with 12.74 J/cm2 of blue light, one PDT dose at day 1, induced a significant tumour growth delay at day 3, which was not maintained in time. Therefore, we administered a second PTN-PDT boost on day 3. Under these conditions, the delay of tumour growth was 28% both on days 3 and 4 of the experiment (*p < 0.05 control vs. PTN-PDT, two-way ANOVA, followed by Sidak’s multiple comparisons test). Histology of tumours revealed massive tumour necrosis up to 4 mm of depth. Intriguingly, a superficial area of viable tumour in the 1 mm superficial area, and a quite conserved intact skin was evidenced. We hypothesize that this may be due to PTN aggregation in contact with the skin and tumour milieu of the most superficial tumour layers, thus avoiding its photochemical properties. On the other hand, normal skin treated with PTN-PDT exhibited slight histological changes. These preliminary findings encourage further studies of natural AQs administered in different vehicles, for topical treatment of cutaneous malignancies.

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“…Breast cancer cutaneous metastases are incurable and the treatment is directed towards local control with surgical excision, radiation, and chemotherapy [47]. Therefore, considering that the mean human epidermal thickness ranges from 56.6 to 81.5 µm [48], patients at early stages of the disease, without epidermal invasion, could bene t from PTN-PDT topical treatment in combination with other established therapies.…”

Section: Discussionmentioning

confidence: 99%

Topical Application of the Anthraquinone Parietin and Blue Light Illumination Induces Delayed Cell Growth and Necrosis in the Deeper Layers of a Subcutaneously Implanted Tumour

Mugas

Calvo

Marioni

et al. 2021

Preprint

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Photodynamic therapy (PDT) is an anticancer treatment involving administration of a tumour-localizing photosensitizer, followed by activation by light of a specific wavelength.In previous work, we showed that the natural anthraquinone (AQ) Parietin (PTN), was a promising photosensitizer for photodynamic therapy of leukemic cells in vitro. The present work aimed to analyze the photosensitizing ability of PTN in the mammary carcinoma LM2 cells in vitro and in vivo in a model of subcutaneously implanted tumours.Photodynamic therapy mediated by Parietin (PTN-PDT) (PTN 30 µM, 1 h and 1.78 J/cm2 of blue light) impaired cell growth and migration of LM2 cells in vitro. PTN per se induced a significant decrease in cell migration, and it was even more marked after illumination (migration index was 0.65 for PTN and 0.30 for PTN-PDT), suggesting that both PTN and parietin-mediated PDT would be potential inhibitors of metastasis.Fluorescence microscopy observation indicated cytoplasmatic localization of the AQ and no fluorescence at all was recorded in the nuclei.When PTN (1.96 mg) dissolved in dimethyl sulfoxide was topically applied on the skin of mice subcutaneously implanted with LM2 cells, PTN orange fluorescence was strongly noticed in the stratum corneum and also in the inner layers of the tumour up to approximately 5 mm. After illumination with 12.74 J/cm2 of blue light, one PDT dose at day 1, induced a significant tumour growth delay at day 3, which was not maintained in time. Therefore, we administered a second PTN-PDT boost on day 3. Under these conditions, the delay of tumour growth was 28 % both on days 3 and 4 of the experiment.Histology of tumours revealed massive tumour necrosis up to 4 mm of depth. Intriguingly, a superficial area of viable tumour in the 1 mm superficial area, and a quite conserved intact skin was evidenced. We hypothesize that this may be due to PTN aggregation in contact with the skin and tumour milieu of the most superficial tumour layers, thus avoiding its photochemical properties.On the other hand, normal skin treated with PTN-PDT exhibited slight histological changes. These preliminary findings encourage further studies of natural AQs administered in different vehicles, for topical treatment of cutaneous malignancies.

show abstract

Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report

Cited by 6 publications

References 22 publications

A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy

A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy

Photosensitization of a subcutaneous tumour by the natural anthraquinone parietin and blue light

Topical Application of the Anthraquinone Parietin and Blue Light Illumination Induces Delayed Cell Growth and Necrosis in the Deeper Layers of a Subcutaneously Implanted Tumour

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