Occult Breast Carcinoma Presenting as Scalp Metastasis

Breast cancer is the most common tumor among women, and approximately 6% of the patients have de novo metastatic breast cancer. Occult breast cancer accounts for only 0.1–0.8% of the cases and most commonly presents with axillary lymphadenopathy. Scalp metastases are rare and have been described as a sign of progression or widespread metastatic disease. Here, we describe a rare case of de novo metastatic breast cancer to the scalp as the single site of spread and without an identifiable primary breast tumor.

[1]  H. Rugo,et al.  Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis , 2017, Breast Cancer Research and Treatment.

[2]  A. Jemal,et al.  Cancer statistics, 2017 , 2017, CA: a cancer journal for clinicians.

[3]  R. Stelini,et al.  Cutaneous metastasis as the first manifestation of occult malignant breast neoplasia* , 2016, Anais brasileiros de dermatologia.

[4]  Markku Miettinen,et al.  GATA3: A Multispecific But Potentially Useful Marker in Surgical Pathology A Systematic Analysis of 2500 Epithelial and Nonepithelial Tumors , 2014, The American journal of surgical pathology.

[5]  S. Dry,et al.  Multisite Validation Study to Determine Performance Characteristics of a 92-Gene Molecular Cancer Classifier , 2012, Clinical Cancer Research.

[6]  Yasuhiro Fujiwara,et al.  Immunohistochemical Profile for Unknown Primary Adenocarcinoma , 2012, PloS one.

[7]  R. Salunga,et al.  Performance and clinical evaluation of the 92-gene real-time PCR assay for tumor classification. , 2011, The Journal of molecular diagnostics : JMD.

[8]  G. Tseng,et al.  An immunohistochemical panel to differentiate metastatic breast carcinoma to skin from primary sweat gland carcinomas with a review of the literature. , 2011, Archives of pathology & laboratory medicine.

[9]  J. Hogue,et al.  Breast cancer scalp metastasis as first metastatic site after scalp cooling: Two cases of occurrence after 7- and 9-year follow-up , 2011, Breast Cancer Research and Treatment.

[10]  W. Woodward,et al.  Population‐based analysis of occult primary breast cancer with axillary lymph node metastasis , 2010, Cancer.

[11]  E. Maunsell,et al.  Incidence of scalp metastases in breast cancer: a retrospective cohort study in women who were offered scalp cooling , 2009, Breast Cancer Research and Treatment.

[12]  R. Salunga,et al.  Molecular classification of human cancers using a 92-gene real-time quantitative polymerase chain reaction assay. , 2009, Archives of pathology & laboratory medicine.

[13]  W. Gerald,et al.  EGFR gene amplification in breast cancer: correlation with epidermal growth factor receptor mRNA and protein expression and HER-2 status and absence of EGFR-activating mutations , 2005, Modern Pathology.

[14]  E. Grabbe,et al.  MRI of the breast in patients with metastatic disease of unknown primary , 1999, European Radiology.

[15]  D. Lookingbill,et al.  Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. , 1993, Journal of the American Academy of Dermatology.