Cutaneous metastasis of occult breast cancer: a case report

Costa, Rafael Everton Assunção Ribeiro da; Reis, Cristiane Amaral dos; Moura, Rafael de Deus; Araújo, Ana Lúcia Nascimento; Oliveira, Fergus Tomás Rocha de; Vieira, Sabas Carlos

doi:10.11604/pamj.2021.40.23.31009

Cited by 5 publications

(7 citation statements)

References 10 publications

(13 reference statements)

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“…Однако иногда метастазы в кожу служат первоначальным проявлением скрытой, оккультной формы РМЖ при отсутствии первичного очага, который не определяется методами медицинской визуализации [3,18,19].…”

Section: Discussionunclassified

“…(2021 г.) сообщают о 3 случаях метастатического поражения кожи при оккультном РМЖ, которые они выявили при поиске в международной базе данных PubMed [3].…”

Section: Discussionunclassified

“…Чаще всего поражаются подмышечные и надключичные лимфатические узлы. На его долю приходится от 0,1 до 1% всех случаев РМЖ [3][4][5]. Медиана возраста пациентов составляет 55 лет [3,6,7].…”

Section: Introductionunclassified

“…На его долю приходится от 0,1 до 1% всех случаев РМЖ [3][4][5]. Медиана возраста пациентов составляет 55 лет [3,6,7].…”

Section: Introductionunclassified

“…Большинство публикаций, посвященных оккультной форме РМЖ с внутрикожными метастазами волосистой части головы, при отсутствии первичного очага касаются описания отдельных случаев [3,[11][12][13].…”

Section: Introductionunclassified

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Isolated metastasis to the scalp in occult breast cancer: a clinical case

Ognerubov,

Sergeev,

Hizhnyak

et al. 2024

J. Mod. Onco.

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Malignancies remain a serious socio-economic health problem worldwide. Among them, breast cancer (BC) in women ranks 1st in the structure and 4th in mortality. Occult breast cancer accounts for 0.1 to 1% of all BC. In this type, metastases to the scalp are extremely rare. This article presents a case of metastatic lesion of the scalp in occult breast cancer. Patient S., 82 years old, presented with a skin tumor in the parietal region, which she noticed about 2 years ago. It has grown recently, with local alopecia and hyperemia around the lesion. A comprehensive examination was performed. Cytology of the punctate showed malignant cells. Mammography and ultrasound showed no specific changes in the breast and lymph nodes. Spiral computed tomography of the chest and abdomen showed no signs of tumor. The lesion was surgically removed. Histological examination revealed adenocarcinoma metastasis. Immunohistochemical examination revealed tumor cells with diffuse and strong expression of estrogen receptors, diffuse and weak expression of progesterone receptors, strong and focal-diffuse expression of cancer embryonic antigen (CEA), and epithelial membrane antigen (EMA). The proliferative activity index of Ki-67 was less than 20%, Her2-neu 0. Considering the morphology and immunohistochemical data, the lesion was a metastasis of breast cancer with a luminal type A molecular biological variant. Skeletal bone scintigraphy revealed no metastatic lesions. The patient was diagnosed with an occult type of breast cancer, stage IV cTxN0M1, with metastasis to the scalp. Hormone therapy with aromatase inhibitors was administered. There were no signs of recurrence during the follow-up for 6 months. Isolated scalp metastasis in occult breast cancer is extremely rare. Practitioners should consider this type of distant metastasis of malignancies in differential diagnosis.

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Section: Discussionunclassified

Section: Introductionunclassified

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Isolated metastasis to the scalp in occult breast cancer: a clinical case

Ognerubov,

Sergeev,

Hizhnyak

et al. 2024

J. Mod. Onco.

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A Case Report of Occult Breast Cancer Detected by Diagnostic Laparoscopy for Suspected Ovarian Cancer

Egami,

Tarumi,

Okamura

et al. 2024

Case Reports in Obstetrics and Gynecology

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Diagnostic laparoscopy is useful in the management of gynecological cancers; however, it can occasionally result in the detection of other malignancies. Occult breast cancer (OBC) is metastatic breast cancer without a recognized primary breast lesion. We report a rare case of OBC that was detected laparoscopically. A 64-year-old female presented to our hospital with back pain. Magnetic resonance imaging (MRI) revealed a 50 mm multicystic tumor with an internal nodule in the right ovary. Positron emission tomography/computed tomography showed abnormal accumulation in multiple lymph nodes, moderate accumulation in the ovarian tumor nodule, and no accumulation in the breasts. Ovarian cancer was suspected, and a diagnostic laparoscopy was performed. Laparoscopically, a cystic tumor in the right ovary and 10 mm nodule in the right round ligament were observed and partially resected. Immunohistopathologically, the nodules of the round ligament exhibited features consistent with those of breast cancer, but the ovarian tumor was a seromucinous borderline tumor. MRI revealed no breast lesions. Therefore, the malignancy was diagnosed as an OBC.

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Occult Invasive Lobular Carcinoma Presenting as an Axillary Skin Metastatic Lesion Underwent Neoadjuvant Endocrine Therapy and Surgical Resection: A Case Report and Review of Literature

Busbait¹,

Alkhalifa²,

Aljohani³

et al. 2022

BCTT

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Introduction Invasive lobular carcinoma (ILC) is the second most common type of breast cancer accounting for 5–15% of all breast cancer cases. It usually presents with nonspecific signs and symptoms. Occult breast cancer presenting as an axillary mass is rare, with prevalence of 0.3–1%, less likely with isolated cutaneous breast metastasis as a first presentation. There are limited data in the literature on patients who underwent endocrine therapy and complete surgical resection. Case Presentation A 54-year-old woman with left axillary skin swelling that had been persisting for 6 years was diagnosed with ILC 18 months ago presenting with an ulcerated axillary skin lesion and was managed with letrozole in another facility as she was estrogen receptor (ER) and progesterone receptor (PR) positive. She received letrozole for 18 months and had a partial response in the form of healing of the ulcer with persistent subcutaneous nodules. Her breast mammogram, ultrasound, and magnetic resonance imaging findings were unremarkable; however, there were few prominent left axillary lymph nodes. A biopsy of the left axillary lymph node was positive for malignancy, consistent with ILC. A skin punch biopsy of the axillary skin lesion showed ILC extending to the dermis with no background breast tissue. The patient underwent left modified radical mastectomy with excision of the left axillary skin lesion. The breast specimen comprised 0.4 mm of ILC as the primary malignancy and nine positive axillary lymph node malignancies. The patient received adjuvant radiotherapy and continued to receive letrozole. There were no signs of complications or recurrence during the follow-up period. Conclusion Ulcerated skin lesions in the axilla should raise concerns regarding breast cancer metastasis. In cases of isolated cutaneous breast metastases, surgical excision can be considered in combination with endocrine therapy.

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Cutaneous metastasis of occult breast cancer: a case report

Cited by 5 publications

References 10 publications

Isolated metastasis to the scalp in occult breast cancer: a clinical case

Isolated metastasis to the scalp in occult breast cancer: a clinical case

A Case Report of Occult Breast Cancer Detected by Diagnostic Laparoscopy for Suspected Ovarian Cancer

Occult Invasive Lobular Carcinoma Presenting as an Axillary Skin Metastatic Lesion Underwent Neoadjuvant Endocrine Therapy and Surgical Resection: A Case Report and Review of Literature

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