Ovarian Cancer Metastatic to the Breast Presenting as Inflammatory Breast Cancer: A Case Report and Literature Review

Abstract

Background. Primary ovarian carcinoma with metastasis to the breast is rare, with only 39 cases reported in the current literature. Ovarian metastasis to the breast presenting as inflammatory breast carcinoma is even more infrequent, with only 6 cases reported.Case. We present a patient who developed metastatic inflammatory cancer of the breast from a stage IIIC papillary serous ovarian adenocarcinoma approximately 1 year after the original diagnosis. Pathologic analysis confirmed the origin of the tumor: a high-grade adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. In addition, the tumor was strongly positive on immunohistochemistry for CA-125, identical to the ovarian primary. The patient died of diffuse metastasis 5 months after the breast tumor was noted.Conclusion. Although ovarian metastasis to the breast presenting as inflammatory breast cancer is rare, it should be included in the differential diagnosis for any patient with a personal history of ovarian cancer. Accurate differentiation is necessary because treatment differs significantly for patients with ovarian metastasis to the breast, as compared with patients with primary inflammatory breast cancer. Ovarian metastasis to the breast confers a poor prognosis: patient survival ranged from 3 to 18 months, with a median survival of 6 months after the diagnosis of the breast metastasis.

Isolated metastatic primary peritoneal carcinoma to the breast: a rare site of disease recurrence

“…5 Less well recognised is a metastasis to breast tissue from peritoneal origin, as in our case. Diagnostic difficulties can arise in the poorly differentiated nature of peritoneal and ovarian carcinomas and this case highlights that close clinicopathological correlation is required when tissue is analysed and patients have undergone treatment for other cancers.…”

Metástase na mama originada de carcinoma ovariano: relato de caso e revisão da literatura

“…Frequently, imaging studies demonstrate metastatic lesions to the breast as dense, circumscribed and noncalcified masses. However, as a function of the presence of psamomatous bodies associated with some ovarian tumors, microcalcifications may be seen in cases of ovarian metastasis to the breast (1) . But such a differentiation may be difficult, considering that metastases to the breast generally do not present specific imaging features (6) .…”

“…According to some studies in the literature, the survival time of patients with breast metastasis from ovarian carcinoma is most of times less than one year (1) .…”

“…Primary ovarian carcinoma rarely originates breast metastasis and there are few cases reported in the literature (1) . Only about 2% of malignant neoplastic breast lesions are of secondary origin and, from a clinical and radiological point of view, they may mimic both primary benign and malignant tumors (2) .…”

Diagnosis and treatment of inflammatory breast cancer

“…It is relatively soft in AM, with the surrounding tissue adhesion, and good activity. In addition, some literatures [3] reported that ovarian cancer and other breast metastases also presented clinical performance of IBC. Lingcheng Wang [4] reported that the clinical manifestations of bilateral breast swelling, orange dermoid change, with axillary lymph node enlargement caused by hydatidiform mole may be misrecognized as IBC.…”