Primary Peritoneal Serous Carcinoma Presenting as Inflammatory Breast Cancer

The Breast Journal (Impact Factor: 1.41). 02/2009; 15(2):176 - 181. DOI: 10.1111/j.1524-4741.2009.00693.x


  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.

Download full-text


Available from: Michael T Deavers,
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 42-year-old woman presented with localized irritation, erythema and sharp pain in the one breast. After unsuccessful treatment for mastitis, an oncology consultation was obtained. A breast biopsy revealed an invasive carcinoma and a diagnosis of inflammatory breast cancer was made. The patient was treated with neo-adjuvant chemotherapy and subsequently underwent bilateral mastectomy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy was also performed at the same time due to the presence of a pelvic mass. Morphologic and immunohistochemical examination of the specimens helped to clarify the correct diagnosis of primary ovarian carcinoma with widespread metastases to bilateral breasts.
    International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists 05/2010; 29(3):243-7. DOI:10.1097/PGP.0b013e3181c18523 · 1.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This report presents a rare case of inflammatory breast metastasis from gastric signet-ring cell carcinoma. The clinical and radiologic findings were similar to those of primary inflammatory carcinoma or acute mastitis. Further, ultrasonography showed diffuse skin thickening and a diffuse infiltrative hypoechoic lesion with marked posterior acoustic shadowing in the left breast. Similarly, magnetic resonance imaging showed diffuse skin thickening/enhancement and a diffuse non-mass-like enhancement in the left breast and to a lesser degree in the right breast.
    Clinical imaging 10/2012; 37(3). DOI:10.1016/j.clinimag.2012.09.005 · 0.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intramammary metastasis (IM) of non-breast cancers are infrequent. The purpose of this review of literature was to update the knowledge and explain diagnostic errors. A review of literature with PubMed was used to select 54 articles published in English between 2003 and 2012. Melanoma (138 cases, 29.8%) were more frequently responsible of 463 cases of MIM, followed by lung, gynecological, gastrointestinal and hematologic cancers. IM occur mainly in women (92.2%), around 50 years, and are metachronous (84.2%). Clinically, they are usually round, painless, without skin retraction and associated with adenopathies (33%). In imaging, they are frequently single. Diagnosis, sometimes evoked by morphological study of the tumor, is confirmed by immunohistochemistry. Systemic metastasis are common, involving a shorter survival. The prevalence of primitive cancers is not alone responsible for the frequency of IM, as we can observe it with melanoma. The "seed and soil" hypothesis of Paget may explain it: some tumor cells grow preferentially in selected organs. Vascularity of the breast also seems to be an important factor. Clinically, IM can be confused with benign tumors. However, a history of cancer and multiple lesions should raise the suspicion of malignancy. In imaging, signs are non-specific. The morphological characteristics do not confirm the diagnosis with certainty. Immuno-histochemistry is fundamental, as the comparison with the histology of primary tumor. Support is mainly palliative.
    Gynécologie Obstétrique & Fertilité 10/2013; · 0.52 Impact Factor
Show more