Squamous cell carcinoma of the hand metastasized to the breast: A unique case

Abstract

Metastatic squamous cell carcinoma (SCC) to the breast is a very rare entity with a few cases reported in the literature, while the hand as an extra-mammary origin site for this type of malignancy has not been reported before. We describe a unique case of a woman with a SCC lesion excised from the right index finger that metastasized to her ipsilateral breast. A 68-year-old female patient presented with a small palpable lesion of the right breast and without any skin ulceration or malformation. Ultrasonography and computed tomography studies revealed a solitary metastatic lesion of the breast, without any multiple disease or lymphadenopathy diagnosed. Fine Needle Aspiration (FNA) cytology confirmed the correlation of the lesion with the primary site. The patient underwent further surgical and oncological management. The use of FNA cytology is important to distinguish a metastasis from primary breast cancer in order to avoid unnecessary conflicting treatments, even when the medical history is not typical or revealing. SCCs of the hand can give metastases to unusual sites such as the breast and must always be closely followed-up, even if they are successfully excised in healthy margins originally.

Combined Use of Unguided FNA and CNB Increases the Diagnostic Accuracy for Palpable Breast Lesions

“…Testing for breast cancer (BC) biomarkers including immunohistochemistry for estrogen and progesterone receptors and in situ hybridization for HER2 can also be done in FNA samples . Moreover, FNA can also serve to confirm the diagnosis of metastatic neoplasms to the breast in suspected cases . However, the use of FNA is rapidly declining in favor of CNB even for palpable lesions .…”

Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review

“…In addition to anatomically well-defined regional lymph nodes, other sites may harbour cSCC metastases (86)(87)(88)(89). These unusual sites may be identified by imaging while staging or as an incidental report.…”