A rare case of massive cutaneous metastases in breast carcinoma.

To cite: Holton J, Chapman G. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013202839 DESCRIPTION An 82-year-old woman with a medical history of breast carcinoma presented with fatigue and failure to cope at home. Widespread malignant disease was found, including multiple cutaneous lesions and pulmonary metastases. Following review from the local oncology unit, the decision was taken to proceed with palliative care and the patient died 1 week later. This image (figure 1), taken on admission, shows a large nodular cutaneous metastatic carcinoma. The nodular form is the most common manifestation of cutaneous spread from breast carcinoma. However, deep ulceration is evident, which is a rare feature of nodular cutaneous metastatic carcinoma. Other forms of cutaneous metastases from breast carcinoma include telangiectatic, en cuirasse and inflammatory metastatic carcinoma. Cutaneous metastases are more commonly found in the context of breast carcinoma than any other malignancy. A large retrospective study showed 23.9% of women with metastatic breast carcinoma had cutaneous metastases. In addition, the presence of cutaneous metastases from breast carcinoma often indicates widespread dissemination of disease and therefore carries a poor prognosis. Treatment is often palliative. Recognising cutaneous metastases gives clinicians a better insight into the patient’s prognosis, and therefore guidance towards the appropriate investigations and further management for each individual.