Metastatic breast disease from cutaneous malignant melanoma

Multimodality imaging review of metastatic melanoma involving the breast

Melanoma is among the most commonly reported non-mammary primary tumors to metastasize to the breast. Unfortunately, evidence of melanoma metastasis to any site portends a poor prognosis. Imaging studies can be useful in the early detection of metastatic melanoma which is essential for appropriate management of this disease. There have been very few previous studies on the imaging findings of metastatic melanoma especially across multiple imaging modalities. This review aims to describe these imaging features seen on mammography, ultrasound, magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography computed tomography (FDG PET/CT) using three case examples. Our findings, consistent with previous studies, describe melanoma metastases to the breast as largely non-specific, round or oval masses with circumscribed margins and homogeneous internal enhancement.

Treated Primary Cutaneous Malignant Melanoma With Later Metastasis Found in Clinical Presentation of Left Axilla Lymphadenopathy: A Case Report

This case report details the rare instance of metastatic spread of cutaneous malignant melanoma to the breast in a 50-year-old female. The patient presented with a palpable axillary mass confirmed to be metastasis despite excision and closure of the primary malignancy. The mass seen in clinical and radiological presentations presented with features of complicated differentiation from a primary breast tumor. Biopsy and staining with immunohistochemical markers S100 and Sox10 played a critical role in confirming the melanocytic origin of this metastatic lesion. Breast metastases are associated with poor prognosis, and this case emphasizes the importance of in-depth evaluations for patients with a history of malignant melanoma and the need for ongoing clinical awareness in this field.

Rare Primary Malignant Melanoma of the Breast Presenting as a Solitary Breast Mass in a 43-Year-Old Male

Primary malignant melanoma of the breast (PMMB) is an extremely rare lesion that carries a poor prognosis. Therefore, it is crucial to examine the patient's medical history, clinical presentation, and histopathology considering this diagnosis. The rarity of this lesion has made it difficult to identify classic presentations or specific treatment guidelines. Staining for specific biomarkers can be helpful for diagnosis in the absence of melanin pigment on histology. Additional molecular studies to determine gene status can also be useful for targeted immunotherapy and increased survival time for patients. In this paper, we introduce a rare case of PMMB without skin involvement presenting as a solitary breast mass in a male and explore the radiology, histology, evaluation, and treatment options.

A Spectrum of Metastases to the Breast: Radiologic-Pathologic Correlation

Metastases to the breast from non-mammary origin are rare. The majority of these lesions appear as secondary manifestations of melanoma and lymphoma, followed by lung carcinomas, gynecological carcinomas, and sarcomas. There has been a steady trend of an increase in diagnosis of intramammary metastases owing to the current advances in imaging technology. Imaging features depend on the type of primary neoplasm and route of dissemination, some of which resemble primary breast cancer and benign breast entities. There are certain imaging features that raise the level of suspicion for metastases in the correct clinical context. However, imaging manifestations of intramammary metastases do not always comply with the known classic patterns. The aim of this review is to clarify these features, emphasizing radiologic-pathologic correlation and a multidisciplinary approach, since most cases are found in patients with advanced disease.

Recurrent malignant melanoma presenting as multiple bilateral breast masses: A case report

Malignant melanoma is a tumor that originates from melanocytes. Melanoma commonly metastasizes to the lungs, brain, or any other solid organ. Herein, we describe the case of a 69-year-old woman with a previous history of cutaneous melanoma who presented with a newly developed palpable breast mass. Subsequent imaging findings and histopathologic examination results of biopsy specimens revealed bilateral breast masses consistent with malignant melanoma. Most breast malignancies originate from a primary breast cancer tissue. This case highlights the importance and implications of obtaining a complete medical history when evaluating the possible outcomes of malignant melanoma.

Metastatic melanoma presenting as a breast mass - role of radiologist as a clinician

Breast tissue can be the host of not only many benign and malignant tumors but can also be a metastatic site for various tumors such as leukemia, lung cancer, and melanoma. This report describes an unusual case of a 43-year-old female who presented with a new palpable breast lump and several similar extramammary lumps on her skin. A melanoma panel, consisting of S100, HMB45, and Melan-A stains, was included in the pathology evaluation due to diagnostic suspicion of the radiologist and revealed metastatic melanoma. This case highlights the importance of detailed history and relevant physical exam as well as clinical and imaging correlation. It serves as a reminder to radiologists to include metastatic melanoma in the differential of suspicious subcutaneous breast masses, especially in patients with multiple subcutaneous lumps in the body or abnormal skin findings.

Metastatic Malignant Melanoma Mimicking Mammary Mass: A Rare Presentation

Breast lump in perimenopausal women is considered a primary malignancy unless proved otherwise. Metastasis to the breast from extramammary sites is rare. Malignant melanoma (MM) is known for its ability to spread to distant sites, which can be both hematogenous and lymphatic. The common sites are skin, lung, liver, brain, etc. However, reports of melanoma metastasizing to the breast are rare. We present a case of 50-year-old female patient, who underwent wide local excision and split skin grafting for MM right leg. She did not undergo any adjuvant therapy and one year later presented to us with a solitary lump occupying the upper inner quadrant of the right breast. The breast lump turned out to be metastatic deposit from MM based on the presence of melanin in cells on fine needle aspiration cytology (FNAC). Therefore, breast lump in perimenopausal is not always a primary malignancy, and differential diagnosis should also include metastatic tumors.

Malignant melanoma of the breast: controversies in the diagnosis and therapeutic management of a rare nosologic entity

Melanoma of the breast is an infrequent entity, presenting as either primary or metastatic from extramammary solid neoplasms. Depending on the involvement of the skin, primary malignant melanoma of the breast (PMMB) can be classified as cutaneous or noncutaneous. Cutaneous PMMB accounts for <5% of all melanomas and only 0.5% of all breast cancers. Furthermore, despite the rarity of metastatic breast neoplasms, melanoma comprises a frequent source of metastases. Metastatic potential of melanoma is associated with poor prognosis, and the majority of patients present more than one metastatic foci at the time of diagnosis. Diagnostic approach for both primary and metastatic melanomas of the breast is substantiated by fine needle aspiration (FNA) cytology along with immunohistochemistry. Nevertheless, verification of a metastatic mammary melanoma requires the discovery of a primary lesion. The mainstay of treatment for primary tumors is surgery, with radical local excision and axillary lymph node dissection or, on occasion, axillary sentinel node resection, while for metastatic tumors it depends on the specificities of the melanoma. Adjuvant therapy is always implemented. The aim of this survey is to meticulously review the literature of primary and metastatic malignant melanomas of the breast and report epidemiologic and clinicopathologic data for this rare entity. Clinical features, histogenesis, morphological, and immunochemical findings are discussed, while the role of current diagnostic and therapeutic management of this uncommon entity is emphasized.

A Case Series of Breast Metastases from Different Extramammary Malignancies and Their Literature Review

Metastasis to the breast from all other primary sites is unusual. Twelve patients were diagnosed between 2007 and 2017 at National Cancer Institute, Mexico. Solitary or multiple masses, round or oval, and hypoechoic and solid lesions with posterior acoustic shadowing were patterns commonly reported in these patients; other arrangements include diffuse involvement of the breast simulating an inflammatory carcinoma. The development of a breast metastasis is revealed, in our experience, as a negative prognostic factor. Thus, the radiologist should know about the varied appearance of metastatic breast lesions and provide radiopathological correlations when available.

Breast Metastasis from Cutaneous Malignant Melanoma Mimicking a Breast Cancer

Introduction

Breast metastases are very uncommon, either from solid tumors or malignant melanoma.

Case report

We present the case of a 42-year-old woman with a history of cutaneous melanoma of the shoulder excised 21 years ago. She presented with a palpable lump in the upper outer quadrant of the right breast. Ultrasound demonstrated a solid mass within a cystic lesion. A core biopsy was taken and first histology reported a poorly differentiated primary breast cancer suspected to be triple negative. MRI detected a satellite lesion in the same breast, a focus of suspected enhancement in the other breast, and the extramammary finding of an enhancing pulmonary lesion. Staging computed tomography detected widespread metastases to the lungs, brain, subcutaneous left shoulder, liver, pancreas, and hepatorenal recess. A core biopsy was taken from the left breast lesion and the previous slides were reviewed; histopathology and immunohistochemistry were in keeping with metastasis from melanoma.

Conclusions

The possibility of a metastatic lesion to the breast should be taken into account in any patient presenting with a breast lump and a previous history of melanoma. Breast involvement cannot be considered an isolated finding, as it might be the first manifestation of widespread disease.

5-Fluorouracil ethosomes - skin deposition and melanoma permeation synergism with microwave

This study focuses on the use of ethosome and microwave technologies to facilitate skin penetration and/or deposition of 5-fluorouracil in vitro and in vivo. Low ethanol ethosomes were designed and processed by mechanical dispersion technique and had their size, zeta potential, morphology, drug content and encapsulation efficiency characterized. The skin was pre-treated with microwave at 2450 MHz for 2.5 min with ethosomes applied topically and subjected to in vitro and in vivo skin drug permeation as well as retention evaluation. The drug and/or ethosomes cytotoxicity, uptake and intracellular trafficking by SKMEL-28 melanoma cell culture were evaluated. Pre-treatment of skin by microwave promoted significant drug deposition in skin from ethosomes in vitro while keeping the level of drug permeation unaffected. Similar observations were obtained in vivo with reduced drug permeation into blood. Combination ethosome and microwave technologies enhanced intracellular localization of ethosomes through fluidization of cell membrane lipidic components as well as facilitating endocytosis by means of clathrin, macropinocytosis and in particularly lipid rafts pathways. The synergistic use of microwave and ethosomes opens a new horizon for skin malignant melanoma treatment.

Renal cell carcinoma with isolated breast metastasis

Renal cell carcinoma (RCC) is a highly prevalent disease worldwide with many cases being metastasised to various organs during the time of initial presentation. Metastatic RCC to the breast is a rare entity and can mimic primary breast carcinoma. In this article, we present a 63-year-old Caucasian woman presented with a breast mass that was detected by screening mammography and found to have a biopsy proven grade-II clear RCC in the breast tissue. Despite the high incidence and prevalence of primary breast cancer, metastasis from extramammary should be suspected in patients with a prior history of other cancers. In this brief literature review, we also highlight the survival benefit from surgery and close follow-up in selected group of patients with metastatic, metachronous and solitary RCC.

Intramammary metastatic melanoma of unknown primary origin in a 58-year old patient: a case report

BACKGROUND

Malignant melanoma metastasis to the breast is a rare disease.

CASE PRESENTATION

We present the case of a 58-year-old postmenopausal Caucasian woman with metastatic malignant melanoma of unknown origin of the right breast. She presented with a palpable lump in the inferior quadrant of her right breast. The investigations concluded it was breast metastasis from a malignant melanoma of unknown origin. The treatment consisted of mastectomy and axillary lymph node dissection. Two lymph nodes were positive for tumor cells and one showed extracapsular extension. Our patient did not receive immediate adjuvant therapy. Six weeks after the surgery, our patient presented a relapse in the right axilla (a 6 × 4 cm mass) with positive internal mammary lymph nodes and a single brain metastasis. This relapse motivated an adjuvant treatment with partial regression of the disease. Currently, our patient presents multiple metastases with poor prognosis.

CONCLUSIONS

From this experience, we advocate an immediate aggressive handling of melanoma metastasis to the breast.

Anorectal melanoma metastatic to the breast: a case report and review of the literature

Melanoma develops from melanocytes and typically occurs on the skin and mucosa with a high degree of malignancy. Intensive local invasion and distant metastasis of melanoma result in poor patient prognosis, owing to frequent metastases to the lungs, bones, brains, and other parts of the body. In the present study, we report a case of anorectal melanoma in a 56-year-old woman who was admitted to our hospital because of local recurrence 9 months after local resection. She subsequently underwent radical surgery. Metastasis to the left breast occurred within 4 months after radical surgery. Metastasis of anorectal melanoma to the breast is very rare. In the present case report and literature review, we analyzed the clinical manifestation, diagnosis, and treatment of anorectal melanoma metastatic to the breast.