Breast cancer with scalp metastases: a case report
Abstract Background While breast cancer is the most common cancer in women, cutaneous metastases are rare in breast cancer. Additionally, scalp involvement in breast cancer metastasis is extremely rare. That being said, scalp lesions should always be thoroughly investigated to distinguish metastatic...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-023-03928-8 |
| _version_ | 1827943416297684992 |
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| author | Ahmad M. Abdulraheem Duha Naji Ammar N. Al Heyasat Mohammad Alhasan Nidal M. Almasri Raghad Odeh |
| author_facet | Ahmad M. Abdulraheem Duha Naji Ammar N. Al Heyasat Mohammad Alhasan Nidal M. Almasri Raghad Odeh |
| author_sort | Ahmad M. Abdulraheem |
| collection | DOAJ |
| description | Abstract Background While breast cancer is the most common cancer in women, cutaneous metastases are rare in breast cancer. Additionally, scalp involvement in breast cancer metastasis is extremely rare. That being said, scalp lesions should always be thoroughly investigated to distinguish metastatic lesions from other neoplasms. Case presentation A 47-year-old female Middle-Eastern patient presented with metastatic breast cancer in the lungs, bone, liver, and brain with no signs of multiple organ failure, in addition to cutaneous metastases, including the scalp. Between 2017 and 2022, she was managed through modified radical mastectomy, radiotherapy, and several lines of chemotherapy. She presented in September of 2022 with enlarging scalp nodules, which started developing 2 months prior to her presentation. Physical examination revealed firm, non-tender, and immobile skin lesions. Magnetic resonance imaging scan of the head showed soft tissue nodules in different sequences. A punch biopsy was taken from the largest scalp lesion and showed metastatic invasive ductal carcinoma. A panel of immunohistochemistry stains was applied, because a single specific marker for differentiating primary cutaneous adnexal tumors or other malignant neoplasms from breast cancer has not yet been identified. The panel showed positive estrogen receptor 95%, progesterone receptor 5%, negative human epidermal growth factor receptor 2, positive GATA binding protein 3, positive cytokeratin-7, negative P63, and negative KIT (CD117). Conclusion Breast cancer metastases to the scalp are extremely uncommon. When a scalp metastasis is present, it might be the only symptomatic sign of disease progression or widespread metastatic lesions. However, such lesions warrant a comprehensive radiologic and pathologic workup to rule out other possibilities of skin pathologies, such as sebaceous skin adenocarcinoma as it effects the management plan. |
| first_indexed | 2024-03-13T10:15:14Z |
| format | Article |
| id | doaj.art-d81475bff8fd4c8c80d25dea5d44a5a6 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-13T10:15:14Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-d81475bff8fd4c8c80d25dea5d44a5a62023-05-21T11:17:13ZengBMCJournal of Medical Case Reports1752-19472023-05-011711710.1186/s13256-023-03928-8Breast cancer with scalp metastases: a case reportAhmad M. Abdulraheem0Duha Naji1Ammar N. Al Heyasat2Mohammad Alhasan3Nidal M. Almasri4Raghad Odeh5Department of Internal Medicine, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterDepartment of Pathology and Laboratory Medicine, King Hussein Cancer CenterSchool of Medicine/University of JordanAbstract Background While breast cancer is the most common cancer in women, cutaneous metastases are rare in breast cancer. Additionally, scalp involvement in breast cancer metastasis is extremely rare. That being said, scalp lesions should always be thoroughly investigated to distinguish metastatic lesions from other neoplasms. Case presentation A 47-year-old female Middle-Eastern patient presented with metastatic breast cancer in the lungs, bone, liver, and brain with no signs of multiple organ failure, in addition to cutaneous metastases, including the scalp. Between 2017 and 2022, she was managed through modified radical mastectomy, radiotherapy, and several lines of chemotherapy. She presented in September of 2022 with enlarging scalp nodules, which started developing 2 months prior to her presentation. Physical examination revealed firm, non-tender, and immobile skin lesions. Magnetic resonance imaging scan of the head showed soft tissue nodules in different sequences. A punch biopsy was taken from the largest scalp lesion and showed metastatic invasive ductal carcinoma. A panel of immunohistochemistry stains was applied, because a single specific marker for differentiating primary cutaneous adnexal tumors or other malignant neoplasms from breast cancer has not yet been identified. The panel showed positive estrogen receptor 95%, progesterone receptor 5%, negative human epidermal growth factor receptor 2, positive GATA binding protein 3, positive cytokeratin-7, negative P63, and negative KIT (CD117). Conclusion Breast cancer metastases to the scalp are extremely uncommon. When a scalp metastasis is present, it might be the only symptomatic sign of disease progression or widespread metastatic lesions. However, such lesions warrant a comprehensive radiologic and pathologic workup to rule out other possibilities of skin pathologies, such as sebaceous skin adenocarcinoma as it effects the management plan.https://doi.org/10.1186/s13256-023-03928-8Breast cancerScalp metastasesImmunohistochemistry |
| spellingShingle | Ahmad M. Abdulraheem Duha Naji Ammar N. Al Heyasat Mohammad Alhasan Nidal M. Almasri Raghad Odeh Breast cancer with scalp metastases: a case report Journal of Medical Case Reports Breast cancer Scalp metastases Immunohistochemistry |
| title | Breast cancer with scalp metastases: a case report |
| title_full | Breast cancer with scalp metastases: a case report |
| title_fullStr | Breast cancer with scalp metastases: a case report |
| title_full_unstemmed | Breast cancer with scalp metastases: a case report |
| title_short | Breast cancer with scalp metastases: a case report |
| title_sort | breast cancer with scalp metastases a case report |
| topic | Breast cancer Scalp metastases Immunohistochemistry |
| url | https://doi.org/10.1186/s13256-023-03928-8 |
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