Metastatic cutaneous breast carcinoma: A case report and review of the literature

Abstract

Cutaneous metastatic carcinoma, also known as carcinoma erysipeloides, is an unusual clinical finding. In women, it is most frequently found in association with breast cancer rather than other visceral malignancies. Breast cancer patients can present with cutaneous manifestations of breast disease at the time of their initial diagnosis; however, cutaneous metastases more often present well after the initial diagnosis and treatment of the breast disease. Prompt recognition of skin metastases by the plastic surgeon, especially during the delayed setting of reconstructive surgery following mastectomy, allows for earlier intervention in treating the systemic spread of the disease. A clinical case of carcinoma erysipeloides presenting in this delayed setting is outlined in the present report, along with a review of the literature. Key Words: Breast cancer; Carcinoma erysipeloides; Cutaneous metastasesUn carcinome cutané métastatique du sein : Un rapport de cas et une analyse bibliographiqueLe carcinome cutané métastatique, ou carcinome érysipéloïde, est une observation clinique inhabituelle. Chez les femmes, il s'associe plutôt au cancer du sein qu'aux autres tumeurs malignes viscérales. Les patientes atteintes du cancer du sein peuvent présenter des manifestations cutanées de ce cancer au moment du diagnostic. Cependant, les métastases cutanées font beaucoup plus souvent leur apparition bien après le diagnostic initial et le traitement de la maladie cancéreuse. Un dépistage rapide des métastases cutanées par le chirurgien plastique, notamment dans le cadre reporté de la chirurgie reconstructive après une mastectomie, permet une intervention plus rapide pour éviter la propagation systémique de la maladie. Le présent rapport expose un cas clinique de carcinome érysi-péloïde, de même qu'une analyse bibliographique dans un tel contexte. C utaneous metastatic carcinoma is an unusual clinical finding. Review of the literature indicates that the incidence of cutaneous metastases for all types of carcinomas ranges from 0.7% to 10.0% (1-3). Similarly, a more recent meta-analysis (4) demonstrated the overall incidence to be closer to 5.3%. Metastatic cutaneous lesions are more often found in women with breast cancer, than in those with other visceral malignancies, with an incidence exceeding 20% (3-6). Often, the cutaneous lesions do not become apparent until quite some time has passed from the initial treatment of the original carcinoma.

Skin metastases: three-year study of 50 cases in a university center

“…Furthermore, in our study, breast metastases were frequently found on the anterior chest, a common place for this malignancy, as cited in the literature 2,17 , but also on the head and limbs. Lung carcinomas preferred the thorax and also the head and neck, whereas the digestive tract and ovary predilection for the abdomen was once again confirmed 14 .…”

La radioterapia nelle metastasi cutanee da carcinoma mammario: case report

“…In alcuni casi si può avere anche una diffusione cutanea, sia locoregionale (cioè vicino alla sede dell'intervento di asportazione) sia a distanza (in una zona di cute non vicina alla mammella trattata chirurgicamente). Nava e Greer [9], riferendosi ai carcinomi mammari, riportano un'incidenza di metastasi cuta nee fino al 24%. In questi casi non bisogna sottovalutare assolutamente la situazione: le metastasi cutanee possono essere infatti il primo riscontro clinico di metastatizzazione diffusa oltre la cute [10].…”

A rare case of cellulitis‐like cutaneous metastasis of gastric adenocarcinoma

“…The clinical manifestation of carcinoma erysipeloides indistinguishably resembles erysipelas or cellulitis. However, its specific clinical features such as lack of systemic fever, absence of circulating leukocytosis, and resistance to antibiotics would help to distinguish it from acute infectious diseases 7 . We could not suspect metastatic skin carcinoma at the first visit as the symptoms and laboratory data (elevated C‐reactive protein and leukocytosis) were compatible with those of cellulitis.…”