Solitary scalp metastatic lesion as a sign of breast cancer recurrence—a case report
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Scalp tumors are rare and account only for 2%. Nevertheless, the scalp region accounts for 4–6.9% of all cutaneous metastases. Metastatic cutaneous lesions are more often found in women with breast cancer than in those with other internal malignancies.
A 59-year-old woman, who had been clinically diagnosed with stage-IIIA (T3 N2a M0) invasive ductal right breast carcinoma in August 2015, was treated by neoadjuvant chemotherapy with good partial response. Breast conservative surgery was done and she received post-operative adjuvant radiotherapy and hormonal treatment with letrozole. Two years later, the patient noticed a slowly growing, painless scalp nodule. A PET-CT scan was performed and demonstrated scalp mass at the left temporal region. Excisional biopsy was performed; histopathologic examination revealed poorly differentiated adenocarcinoma. In addition, detailed immunohistochemical staining was performed. Accordingly, patient was given radiotherapy and second line hormonal treatment was added, with disease-free survival of one year.
Despite its rarity, solitary scalp metastasis should be considered in the differential diagnosis in patients with a history of cancer especially breast cancer.
KeywordsScalp nodule Radiotherapy Chemotherapy Ductal breast carcinoma Hormonal therapy
We would like to express our gratitude to Dr. Eman Khaled and Dr. Walaa Ahmed Al-Sayed for their contribution regarding histopathological examination.
Compliance with ethical guidelines
Conflict of interest
A.A.M. Abdelhafeez, W. Ibrahim, and W. Elsherief declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from the patient for publication of this case report, including any associated images. A copy of the written consent is available for review by the editor(s) of this journal.
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