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Case Reports
. 2010 Jun 2:1:27-31.
doi: 10.7150/jca.1.27.

Ovarian cancer metastatic to the breast presenting as inflammatory breast cancer: a case report and literature review

Rebecca L Klein  1 , Amanda R Brown, Christian M Gomez-Castro, Setsuko K Chambers, Janiel M Cragun, Lauren Grasso-Lebeau, Julie E Lang
Affiliations
Case Reports

Ovarian cancer metastatic to the breast presenting as inflammatory breast cancer: a case report and literature review

Rebecca L Klein et al. J Cancer. .

Abstract

Background. Primary ovarian carcinoma with metastasis to the breast is rare, with only 39 cases reported in the current literature. Ovarian metastasis to the breast presenting as inflammatory breast carcinoma is even more infrequent, with only 6 cases reported.Case. We present a patient who developed metastatic inflammatory cancer of the breast from a stage IIIC papillary serous ovarian adenocarcinoma approximately 1 year after the original diagnosis. Pathologic analysis confirmed the origin of the tumor: a high-grade adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. In addition, the tumor was strongly positive on immunohistochemistry for CA-125, identical to the ovarian primary. The patient died of diffuse metastasis 5 months after the breast tumor was noted.Conclusion. Although ovarian metastasis to the breast presenting as inflammatory breast cancer is rare, it should be included in the differential diagnosis for any patient with a personal history of ovarian cancer. Accurate differentiation is necessary because treatment differs significantly for patients with ovarian metastasis to the breast, as compared with patients with primary inflammatory breast cancer. Ovarian metastasis to the breast confers a poor prognosis: patient survival ranged from 3 to 18 months, with a median survival of 6 months after the diagnosis of the breast metastasis.

Keywords: breast cancer; breast cancer metastasis; inflammatory breast cancer; ovarian cancer; ovarian cancer metastasis.

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Conflict of interest statement

Conflict of Interest: The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
Picture demonstrating the inflammatory changes present on initial presentation.
Figure 2
Figure 2
Picture demonstrating the size discrepancy between the two breasts.
Figure 3
Figure 3
MR images (T1, T2, post-contrast subtracted and MIP) demonstrating a large segmental area of heterogeneous enhancement in the right central breast. There is also abnormal skin enhancement, thickening and edema (straight arrows) consistent with inflammatory changes related to dermal lymphatic involvement. Significant right axillary lymphadenopathy is also present (curved arrow).
Figure 4
Figure 4
Post contrast subtracted with CAD stream MR image shows a 7.8 cm x 4.2 cm heterogeneously enhancing mass containing several foci of rapid washout (Type III kinetics) compatible with carcinoma.
Figure 5
Figure 5
Intermediate power microscopic image depicting metastatic tumor cells involving superficial dermal lymphatics.
See this image and copyright information in PMC

References

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    1. Ozguroglu M, Ersavasti G, Ilvan S. et al.Bilateral inflammatory breast metastases of epithelial ovarian cancer. Am J Clin Oncol. 1999;22(4):408–10. - PubMed
    1. Moore D, Wilson D, Hurteau J. et al.Gynecologic cancers metastatic to the breast. J Am Coll Surg. 1998;187:178–81. - PubMed
    1. Kayikçioglu F, Boran N, Ayhan A, Güler N. Inflammatory breast metastases of ovarian cancer: a case report. Gynecologic Oncology. 2001;83(3):613–6. - PubMed
    1. Baykal C, Tulunay G, Özfuttu A. et al.Breast and ovarian carcinoma in the same patient, metastasis or dual primaries? Turkish Journal of Cancer. 2007;37(1):27–30.

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