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. 2014;5(1):34-6.
doi: 10.1016/j.ijscr.2013.10.014. Epub 2013 Nov 28.

Metastatic breast disease from cutaneous malignant melanoma

Marco Moschetta  1 , Michele Telegrafo  2 , Nicola Maria Lucarelli  2 , Gianluigi Martino  2 , Leonarda Rella  2 , Amato Antonio Stabile Ianora  2 , Giuseppe Angelelli  2
Affiliations

Metastatic breast disease from cutaneous malignant melanoma

Marco Moschetta et al. Int J Surg Case Rep. 2014.

Abstract

Introduction: Malignant melanoma is one of the most rapidly increasing cancer in the world. Breast metastases from melanoma are uncommon but could reflect a widespread disease.

Presentation of case: We report a case of malignant widespread melanoma presenting with bilateral breast nodules in a 39 year-old pre-menopausal Caucasian woman with an history of cutaneous melanoma of the trunk. Breast clinical examination revealed the presence of a hard and mobile lump located on the left breast. Ultrasound detected two bilateral nodules corresponding to oval opacities with well-defined edges and without calcifications or architectural distortion on mammography. Fine needle aspiration cytology performed on both breast nodules confirmed that the breast lesions were metastases from primary cutaneous malignant melanoma. A total-body CT examination detected brain, lung and abdominal lymph nodes metastases.

Discussion: The breast represents an uncommon site of metastatic disease from extra-mammary tumors. Imaging features of breast metastases from melanoma usually do not allow a differential diagnosis with breast primary tumors. Breast metastases may be asymptomatic or palpable as dense and well-circumscribed nodules. Breast metastases indicate a widespread disease and should lead to avoid aggressive surgical procedures because of the poor prognosis of patients affected by metastatic melanoma.

Conclusion: The detection of bilateral breast metastases from melanoma is highly suggestive of metastatic multi-organ disease and could be useful to address the therapeutic approach.

Keywords: Breast; Mammography; Melanoma; Metastasis; Ultrasound.

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Figures

Fig. 1
Fig. 1
A and B US examination. Two breast hypo-echoic nodules with regular edges were detected in the superior medial quadrant of the left breast (A, arrow) and on the inferior inner quadrant of the right breast (B, arrow), respectively. B and C CT scans. Corresponding CT findings of the left (C, arrow) and right (D, arrow) breast nodules appearing as hyper-enhanced lesions. An excavate lung metastasis was also evident in the upper lobe of the right lung (C, arrow head).
Fig. 2
Fig. 2
CT scans. (A) Multiple brain metastases were detected in both cerebral hemispheres (arrow). (B) CT image on the coronal plane showing multiple lung metastases from cutaneous malignant melanoma (arrow).
See this image and copyright information in PMC

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