Abstract

Introduction

Case report

Discussion

References

Discussion
Board

70 yrs woman affected by metastatic mammary carcinoma. She developed cutaneous inflammatory metastases on the mastectomy scar and skull bone metastases. Radioterapy was previously performed only on the chest. Two weeks ago she developed erythemato-violaceous skin lesions on the scalp with tendency to ulcerate and subsequently crusting and superinfection. Concomitantly soft edema of the left periorbital region was detected. The scalp lesions are extremely painful. A skin biopsy specimen shows: dilated vessels with intraluminal proliferation, composed of fibrin and monomorphous round cells with big basophylic nuclei, no atypia nor mitotic activity. Approximately 4.4% of cutaneous metastases occur as inflammatory or erysipelatoydes carcinoma. Breast cancer is the most common tumor presenting with such clinical appearance. Metastatic spreading is via hematogenous, lymphatic, perineural diffusion or direct implantation. When lymphatic obstruction with vessel dilatation is remarkable violaceous cystic-liyke lesions of the skin can be observed giving a pseudo Stewart-Treves syndrome appearance. Such an unusual presentation of breast cutaneous metastases to the scalp might have been the result of direct lymphatic spread of the tumor from the skull to the adjacent skin.

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Poster Number PAfilosa0157
Keywords: carcinoma, metastasis, scalp, breast