1
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Santos BSD, Macêdo ECD, Scabello BNA, Grossi PPDO, Valente NYS. Dermoscopy of neoplastic alopecia secondary to cutaneous metastasis from breast carcinoma. An Bras Dermatol 2024; 99:742-745. [PMID: 38851896 PMCID: PMC11342979 DOI: 10.1016/j.abd.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 06/10/2024] Open
Affiliation(s)
- Bruno Simão Dos Santos
- Department of Dermatology, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.
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2
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Cedirian S, Rapparini L, Sechi A, Piraccini BM, Starace M. Diagnosis and Management of Scalp Metastases: A Review. Diagnostics (Basel) 2024; 14:1638. [PMID: 39125514 PMCID: PMC11311314 DOI: 10.3390/diagnostics14151638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024] Open
Abstract
Scalp metastases (SMs) are particularly noteworthy, representing around 4-7% of cutaneous neoplasms in this region of the body, possibly due to its rich blood supply. Diagnosis of SMs involves a systematic approach encompassing oncologic history, clinical examination, dermoscopy, imaging, and histopathological assessment. Clinical presentations of SM can vary, but dermoscopy reveals unique vascular patterns aiding in diagnosis. Imaging, particularly MRI and CT, and histopathological evaluation are mandatory for definitive diagnosis. Treatment strategies vary depending on tumor characteristics and staging, ranging from surgical excision to systemic therapies like chemotherapy or radiotherapy. Multimodal approaches tailored to individual cases yield optimal outcomes. The diagnostic tools available do not always allow SMs to be diagnosed, and often the lack of knowledge on the part of oncologists in suspecting SMs can delay an early diagnosis. This review provides clinicians with a practical guide for the timely diagnosis and management of SM, emphasizing the importance of a multidisciplinary approach and personalized treatment strategies for improved patient outcomes.
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Affiliation(s)
- Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (S.C.); (B.M.P.); (M.S.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (S.C.); (B.M.P.); (M.S.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (S.C.); (B.M.P.); (M.S.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (S.C.); (B.M.P.); (M.S.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
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3
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Tomasini CF, Fiandrino G, Favale EM, Antoci F, Barruscotti S. Giant Morpheaform Basal Cell Carcinoma Mimicking Scarring Alopecia: Exception Prone to Neglect. Dermatopathology (Basel) 2024; 11:154-160. [PMID: 38921053 PMCID: PMC11202933 DOI: 10.3390/dermatopathology11020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
A 74-year-old woman in good general health presented with a 5-year history of progressive hair loss over several years, interpreted as female androgenetic alopecia (AGA), and was treated with topical 5% Minoxidil without improvement. The patient's relevant medical history revealed infiltrating, triple-negative apocrine carcinoma of the right breast four years before, treated by quadrantectomy, radiation, lymphadenectomy and chemotherapy, with no recurrence at the last follow-up. On examination, there was an asymptomatic 15 × 15 cm firm and whitish area of scarring alopecia on the central scalp. Dermoscopy revealed multiple arborizing vessels and many telangiectasia. The clinical considerations included mainly cutaneous metastasis of breast carcinoma (alopecia neoplastica), pseudopelade of Broque and morpheaform basal cell carcinoma (BCC). A histopathologic examination revealed characteristic changes of morpheaform BCC with basaloid islands and cords of atypical basaloid cells diffusely infiltrating the dermis, embedded in a sclerotic and hypervascularized stroma. Secondary alopecia neoplastica due to morpheaform BCC on the scalp is an exceedingly rare entity, possessing subtle clinical features that may mimic both scarring and non-scarring alopecia. Delayed recognition may contribute to aggressive behavior and extensive local destruction. Treatment with hedgehog inhibitors in locally advanced BCC of the scalp, both in adjuvant and neoadjuvant modalities, is promising.
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Affiliation(s)
- Carlo Francesco Tomasini
- Dermatologic Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.M.F.); (S.B.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Institute of Dermatology, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Giacomo Fiandrino
- Pathology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.F.); (F.A.)
| | - Emanuele Mario Favale
- Dermatologic Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.M.F.); (S.B.)
| | - Francesca Antoci
- Pathology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.F.); (F.A.)
| | - Stefania Barruscotti
- Dermatologic Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.M.F.); (S.B.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Institute of Dermatology, Università degli Studi di Pavia, 27100 Pavia, Italy
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4
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Kitayama S, Katsuumi K, Takatsuka S, Kanbayashi C, Shimizu T, Takenouchi T. Alopecia neoplastica: A manifestation of metastatic breast cancer. SKIN HEALTH AND DISEASE 2023; 3:e302. [PMID: 38047252 PMCID: PMC10690688 DOI: 10.1002/ski2.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/14/2023] [Accepted: 10/04/2023] [Indexed: 12/05/2023]
Abstract
We herein report a typical case of alopecia neoplastica secondary to breast cancer. Alopecia neoplastica is a rare form of alopecia resulting from metastasis of a primary tumour to the scalp and is often misdiagnosed as alopecia areata.
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Affiliation(s)
- Shohei Kitayama
- Division of DermatologyNiigata Cancer Center HospitalNiigataJapan
- Department of DermatologyFaculty of MedicineAcademic AssemblyUniversity of ToyamaToyamaJapan
| | - Koji Katsuumi
- Division of DermatologyNiigata Cancer Center HospitalNiigataJapan
| | - Sumiko Takatsuka
- Division of DermatologyNiigata Cancer Center HospitalNiigataJapan
| | | | - Tadamichi Shimizu
- Department of DermatologyFaculty of MedicineAcademic AssemblyUniversity of ToyamaToyamaJapan
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5
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Borg Grech S, Pisani D, Degaetano J, Boffa MJ. A sinister case of alopecia in a middle-aged woman. Clin Exp Dermatol 2023; 48:276-279. [PMID: 36763698 DOI: 10.1093/ced/llac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/02/2022] [Accepted: 10/19/2022] [Indexed: 01/22/2023]
Abstract
We present the case of a middle-aged woman who presented with multiple indurated areas of hair loss on her scalp. Closer dermoscopic inspection of these patches revealed multiple arborizing vessels on an erythematous background. On further inspection nodules were also noted on the nape of the neck and right breast. Punch biopsies showed diffuse infiltration of the dermis by a neoplastic population of cells with moderate nuclear pleomorphism, abundant eosinophilic cytoplasm and brisk mitotic activity.
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Affiliation(s)
| | - David Pisani
- Department of Histopathology, Mater Dei Hospital, Msida, Malta
| | - James Degaetano
- Department of Histopathology, Mater Dei Hospital, Msida, Malta
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6
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Popa A, Carsote M, Cretoiu D, Dumitrascu MC, Nistor CE, Sandru F. Study of the Thyroid Profile of Patients with Alopecia. J Clin Med 2023; 12:jcm12031115. [PMID: 36769763 PMCID: PMC9918246 DOI: 10.3390/jcm12031115] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Thyroid hormones are required for the physiological growth and maintenance of hair follicles. We aim to study the thyroid profile of patients with alopecia. This is a narrative review. PubMed literature was searched from 2013 to 2022. We followed different types of alopecia: alopecia areata (AA), androgenic alopecia in males and females, telogen effluvium (TE), frontal fibrosing alopecia (FFA), lichen planopilaris, and alopecia neoplastica (AN). AA shares a common autoimmune background with autoimmune thyroid diseases, either sporadic or belonging to autoimmune polyglandular syndromes. Some data suggested that AA is more severe if thyroid anomalies are confirmed, including subclinical dysfunction or positive antithyroid antibodies with normal hormone values. However, routine thyroid screening for patients with AA, if the patients are asymptomatic from a thyroid point of view and they have negative personal and family history of autoimmunity, remains controversial. TE, apart from the autoimmune type, associates thyroid anomalies of a hormonal assay (between 5.7% and 17%). FFA, mostly a postmenopausal entity (however, not exclusive), associates a higher prevalence of thyroid conditions (up to 50%) than the general population. However, these might have an age-dependent pattern, thus the association may be incidental since there are a limited number of studies. Overall, alopecia remains a very challenging condition for patients and physicians; a multidisciplinary team is required to improve the outcome and quality of life. The common autoimmune background is suggestive of some types of alopecia and thyroid disorders, yet, the underlying mechanisms are still a matter of debate. AA, TE, FFA, LPP, and, potentially, female pattern hair loss have been found to be connected with thyroid entities, thus a state of awareness from a dual perspective, of trichology and endocrinology, is helpful.
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Affiliation(s)
- Adelina Popa
- Department of Dermatovenerology, “Carol Davila University” of Medicine and Pharmacy & “Elias” University Emergency Hospital, 011461 Bucharest, Romania
| | - Mara Carsote
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy & “C.I. Parhon” National Institute of Endocrinology, 011461 Bucharest, Romania
- Correspondence:
| | - Dragos Cretoiu
- Department of Cellular and Molecular Biology, and Histology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy & National Institute for Mother and Child Health Alessandrescu-Rusescu, 011461 Bucharest, Romania
| | - Mihai Cristian Dumitrascu
- Department of Obstetrics and Gynaecology, “Carol Davila” University of Medicine and Pharmacy & University Emergency Hospital, 011461 Bucharest, Romania
| | - Claudiu-Eduard Nistor
- Department 4–Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, “Carol Davila” University of Medicine and Pharmacy & Thoracic Surgery Department, “Carol Davila” Central Emergency University Military Hospital, 011461 Bucharest, Romania
| | - Florica Sandru
- Department of Dermatovenerology, “Carol Davila University” of Medicine and Pharmacy & “Elias” University Emergency Hospital, 011461 Bucharest, Romania
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7
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Navarro R, González H, Sambucety P, Hera Magallanes AL, Rodríguez Prieto M. Alopecia neoplastica inducing underlying lytic skull metastasis. Indian J Dermatol 2022; 67:93. [PMID: 35656265 PMCID: PMC9154158 DOI: 10.4103/ijd.ijd_991_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Alopecia neoplastica is a rare type of cutaneous metastasis. The most frequent presentation consists of red-violaceous nodular scarring alopecia located at the parietal area. The most frequent primary tumor locations are the breast and gastrointestinal tract. We report a case of alopecia neoplastica that induced an underlying lytic bone metastasis. After a rigorous literature search, we could not find another case showing this mechanism.
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8
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Flanagan KE, Burns LJ, Pathoulas JT, Walker CJ, Pupo Wiss I, Cornejo KM, Senna MM. Primary Alopecia Neoplastica: A Novel Case Report and Literature Review. Skin Appendage Disord 2021; 7:499-509. [PMID: 34901185 PMCID: PMC8613616 DOI: 10.1159/000516650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/16/2021] [Indexed: 11/19/2022] Open
Abstract
Alopecia neoplastica (AN) is caused by neoplastic cells damaging hair follicles, resulting in patchy hair loss like cicatricial alopecia and alopecia areata. AN has predominantly described cutaneous metastasis to the scalp from primary visceral malignant tumors. Less frequently, AN results from a primary scalp neoplasm. Compared to "secondary AN," there is a paucity of literature on "primary AN." Herein, we present a comprehensive literature review of primary AN and introduce a unique case of amelanotic melanoma causing primary AN. Including our presented case, 11 cases of primary AN have been reported with causative scalp neoplasms including angiosarcoma, hemangioendothelioma, syringomatous carcinoma, ectopic extramammary Paget's disease, and primary desmoplastic melanoma. 27.3% (3 of 11) of cases were misdiagnosed and treated for a primary alopecia, and 36.4% (4 of 11) of lesions were present for multiple years or an unknown amount of time, likely due to difficulty in recognizing scalp lesion or misdiagnosis. All patients required surgical excision with 36.4% (4 of 11) requiring chemotherapy, radiation, or photodynamic therapy. Two patients with scalp angiosarcoma died from their aggressive disease. Due to the risks of malignant primary AN if allowed to progress, primary AN should be considered in patients presenting with scarring alopecia.
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Affiliation(s)
- Kelly E. Flanagan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Laura J. Burns
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James T. Pathoulas
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Chloe J. Walker
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Isabel Pupo Wiss
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kristine M. Cornejo
- Dermatopathology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Maryanne M. Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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9
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Vezzoni R, Toffoli L, Conforti C, Dri A, Retrosi C, di Meo N, Magaton Rizzi G, Signoretto D, Zalaudek I. Breast Cancer-Related Neoplastic Alopecia: A Case Report and Review of the Literature. Skin Appendage Disord 2021; 7:339-345. [PMID: 34604320 DOI: 10.1159/000514566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022] Open
Abstract
Neoplastic alopecia (NA) is defined as an organized hair loss in single or multiple areas of the scalp caused by a primary tumor that has metastasized to the skin of the scalp. Due to its localization and clinical appearance, NA should be placed in differential diagnosis with alopecia areata or other entities. To date, pathognomonic dermoscopic criteria of NA have not yet been described: the absence of classical criteria of other scalp diseases in addition to a major neovascularization with on-focus arborizing vessels and erosions or ulcerations may help the clinician to suspect a diagnosis of secondary alopecia. Dermatologists should pay more attention to these rare forms of secondarism because in exceptional cases, a simple alopecia of the scalp can hide a new, relapsing or metastatic neoplasia.
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Affiliation(s)
- Roberta Vezzoni
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Ludovica Toffoli
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Arianna Dri
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Chiara Retrosi
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Nicola di Meo
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Giovanni Magaton Rizzi
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Diego Signoretto
- Department of Histopathology, Cattinara Hospital of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology and Venereology Department, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
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10
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Cazzato G, Colagrande A, Cimmino A, De Marco A, Romita P, Foti C, Resta L, Ingravallo G. Cutaneous Metastases from Primary Liver Cancers: The Need for Knowledge and Differential Diagnosis. Life (Basel) 2021; 11:life11060559. [PMID: 34198568 PMCID: PMC8231899 DOI: 10.3390/life11060559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/31/2021] [Accepted: 06/12/2021] [Indexed: 02/06/2023] Open
Abstract
Primary skin tumors are certainly more frequent than metastatic tumors, but the latter can sometimes be the first sign of otherwise unrecognized neoplastic pathology and always correspond to an advanced stage of the disease. Among the various neoplasms that can metastasize in cutaneous districts, skin metastases from primary malignant neoplasms from the liver and biliary tract are infrequent, and when they do occur they can pose differential diagnosis problems to the pathologist. Here we present two cases of metastatic skin lesions, respectively originating from the liver and the intrahepatic biliary tract, and we conduct a brief review of the current literature.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-3405203641 (G.C.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Aurora De Marco
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.M.); (P.R.); (C.F.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-3405203641 (G.C.)
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11
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Płachta I, Kleibert M, Czarnecka AM, Spałek M, Szumera-Ciećkiewicz A, Rutkowski P. Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Follicular Differentiation. Int J Mol Sci 2021; 22:4759. [PMID: 33946233 PMCID: PMC8125718 DOI: 10.3390/ijms22094759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/30/2022] Open
Abstract
Neoplasms derived from follicular tissue are extremely rare. Clinically, they are reported as non-symptomatic, slow-growing nodules. These lesions are mainly benign, but the malignant type can occur. Mainly middle-aged people (50-60 years of age) are affected. These carcinomas are mainly localized on the head and neck or torso. They can be locally aggressive and infiltrate surrounding tissue and metastasize to regional lymph nodes. In the minority of cases, distant metastases are diagnosed. Quick and relevant diagnosis is the basis of a treatment for all types of tumors. The patient's life expectancy depends on multiple prognostic factors, including the primary tumor size and its mitotic count. Patients should be referred to a specialized skin cancer center to receive optimal multidisciplinary treatment. This article tries to summarize all the information that is currently available about pathogenesis, diagnosis, and treatment methods of follicular tumors.
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Affiliation(s)
- Iga Płachta
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Marcin Kleibert
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 00-791 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
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12
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Liu YF, Liu LY, Xia SL, Li T, Li J. An Unusual Case of Scalp Metastasis from Breast Cancer. World Neurosurg 2020; 137:261-265. [PMID: 32035211 DOI: 10.1016/j.wneu.2020.01.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND The most common sites of breast cancer metastases are the bone, lung, liver, and brain. Scalp involvement in breast cancer metastasis is extraordinarily rare. CASE DESCRIPTION This study reports a 52-year-old woman who had a history of malignant right breast cancer and underwent a mastectomy. Positron emission tomography/computed tomography revealed a soft tissue nodule measuring 1 × 0.7 cm located subcutaneously on the top left side of the scalp. A scalp mass excision operation was performed with an extended "S"-shaped incision, and the mass was sent for pathology. Immunohistochemistry showed the following results: CK7: +; ER: 2+, 90%; GATA3: +; GCDFP-15: scattered cells+; mammaglobin: -, napsin A: -; and TTF-1: -. These results were consistent with the characteristics of primary right breast cancer, supporting scalp metastasis from breast cancer. CONCLUSIONS Scalp metastasis from breast cancer is an exceedingly infrequent phenomenon. Close attention should be paid to soft tissue masses in patients with a healthy appearance and in those with a history of malignant cancer. When neurosurgeons operate on the mass, the circumscription and depth of the tumor must be given further attention.
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Affiliation(s)
- Yu-Fei Liu
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ling-Yu Liu
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shi-Lin Xia
- Clinical Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Department of Palliative Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tao Li
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Jun Li
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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13
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Omofoye OA, Binello E. Intraventricular metastases from rectal carcinoma: case report and literature review. J Biomed Res 2019; 34:318-322. [PMID: 32701070 PMCID: PMC7386411 DOI: 10.7555/jbr.33.20180133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Intraventricular metastases are a rare occurrence, particularly from a primary colorectal malignancy. To our knowledge, this is the first report of intraventricular metastasis from rectal cancer. A 72-year-old male presented with a new diagnosis of multiple intraventricular lesions, an anterior mediastinal mass and a rectal mass. His workup revealed rectal adenocarcinoma with intraventricular metastases and an incidental thymoma. Ommaya reservoir placement was performed via an awake procedure rather than under general anesthesia due to airway concerns. Cerebrospinal fluid (CSF) cytology was positive for malignancy and consistent with adenocarcinoma. Two weeks postoperatively, the patient underwent whole brain radiation. Although rare, this diagnosis should always be considered in the differential for solitary or multiple intraventricular lesions. CSF sampling is a useful alternative to intraventricular biopsy for diagnosis of intraventricular metastases. Awake placement of Ommaya reservoir is a safe option in the management of patients with intraventricular metastases, especially those who cannot undergo general anesthesia.
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Affiliation(s)
- Oluwaseun A Omofoye
- Department of Neurosurgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Emanuela Binello
- Department of Neurosurgery, Boston Medical Center, Boston, MA 02118, USA
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