Cutaneous metastasis of occult breast cancer: a case report

• Published in: The Pan African medical journal Vol. 40
• Main Authors: Assunção Ribeiro da Costa, Rafael Everton, Amaral dos Reis, Cristiane, Deus Moura, Rafael de, Nascimento Araújo, Ana Lúcia, Rocha de Oliveira, Fergus Tomás, Vieira, Sabas Carlos
• Format: Journal Article
• Language: English
• Published: Kampala African Field Epidemiology Network 08.09.2021; The African Field Epidemiology Network
• Subjects: Biopsy; Breast cancer; Case Report; Case reports; Chemotherapy; Clinical outcomes; Cytokeratin; Estrogens; Histology; Magnetic resonance imaging; Mammography; Mastectomy; Metastasis; Patients; Radiation therapy; Rare diseases; Scintigraphy; Skin cancer; Ultrasonic imaging; Brazil
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2021.40.23.31009

Occult breast cancer (OBC) is characterized by metastatic presentation of undetectable breast tumor on imaging exams. OBC is a rare disease (accounting for 0.3% to 1.0% of all breast cancers) that represents a major diagnostic challenge. The aim of this study was to report a case of OBC with primary presentation of multiple cutaneous metastases with subsequent emergence of bone metastasis. A 70-year female patient had multiple cutaneous metastatic lesions in the left cervical region, left breast, left axillary region, left subscapular region, in three chirodactylus of the right hand and three chirodactylus of the left hand. Imaging tests (mammogram, ultrasonography and magnetic resonance imaging of the breast) did not show alterations. Biopsy, histology sections and immunohistochemistry of the left cervical cutaneous lesion were compatible with OBC. After two years of anastrozole treatment (1mg/day), there was regression of all cutaneous lesions and stabilization of bone metastasis. OBC has a better prognosis. It may exhibit spontaneous regression or respond to less aggressive treatment strategies, as described in this case.