Primary Peritoneal Serous Carcinoma Presenting as Inflammatory Breast Cancer

Abstract

Metastasis to the breast from extramammary malignancies is rare. Nevertheless, its recognition is important because the prognosis and treatment differ from that of primary breast cancer. We report a unique case of primary peritoneal serous carcinoma that initially presented as inflammatory breast cancer. The patient received neoadjuvant chemotherapy for breast cancer and subsequently underwent bilateral total mastectomy and bilateral sentinel lymph node biopsy. She was found to have extensive intralymphatic carcinoma in both breasts, with only focal minimal breast parenchymal involvement, and residual metastatic carcinoma in bilateral sentinel lymph nodes. Further work-up revealed pelvic ascites and omental nodularities. The patient underwent laparoscopic bilateral salpingo-oophorectomy, which revealed high-grade serous carcinoma involving both ovaries and fallopian tubes. Molecular testing of tumor from the ovary and axillary lymph node showed an identical pattern of allelic loss, confirming a common origin for both tumors. To our knowledge, this is the first reported case of an extramammary primary malignancy that not only presented as inflammatory breast cancer but also was diagnosed and initially treated as such.

Metastatic Ovarian Cancer Presenting as Inflammatory Breast Cancer: A Case Report

“…On fewer incidents, breast metastases can present as inflammatory breast carcinoma, which is even more infrequent with metastases to the breast from extramammary cancers (0.2-1.3%) [7]. There are twelve previously published case reports of metastatic ovarian tumors presenting as inflammatory carcinoma over the breast [10][11][12][13][14][15][16][17][18][19]. The most common histological variant of ovarian cancer associated with breast metastases is papillary serous adenocarcinoma.…”

Metastatic serous carcinoma presenting as inflammatory carcinoma over the breast—Report of two cases and literature review

“…On rare occasions, the breast metastases can present as inflammatory carcinoma via lymphatic invasion and the diagnosis in such cases can be challenging, especially in patients with past history of both breast and ovarian malignancies. There are 10 previously published reports of metastatic ovarian/primary peritoneal tumors presenting as inflammatory carcinoma over the breast; however, none of the previously reported cases had a prior history of primary breast carcinoma (Table ).…”

“…On histopathologic examination, metastatic ovarian serous carcinoma can mimic primary invasive ductal carcinoma as well as ductal carcinoma in situ of the breast, with morphologic similarities such as prominent nuclear atypia and cellular pleomorphism. On the other hand, infiltrating lobular carcinoma of breast consists of small, non‐cohesive cells arranged in a single‐file pattern between fibrous stroma and lacks the cytologic atypia seen in infiltrating ductal carcinoma.…”

Primary peritoneal carcinoma metastasizing to breast: a single case report and literature review from clinic to biology

“…It also metastasizes to liver, lung, and brain, but rarely to breast. To our knowledge up to date, only two articles reported PPC with breast metastasis 6 , 11 . In one of these two reports, PPC was diagnosed 11 months after the initial diagnosis of inflammatory breast cancer 11 .…”

“…To our knowledge up to date, only two articles reported PPC with breast metastasis 6 , 11 . In one of these two reports, PPC was diagnosed 11 months after the initial diagnosis of inflammatory breast cancer 11 . In our case, PPC first spread to colon and liver, and clinically presented as primary colon cancer with hepatic metastasis.…”