Metastatic Ovarian Cancer Presenting as Inflammatory Breast Cancer: A Case Report

Abstract

Metastatic ovarian cancer to the breast is a rare presentation, with limited cases reported worldwide. Common sites for distant metastasis in ovarian cancer are to the liver, lung, and pleura [Dauplat et al. Cancer. 1987 Oct 1;60(7):1561-6]. Usually, such cases predict poor prognosis with troublesome management. We present one challenging case of a 54-year-old female patient with recurrent clear cell ovarian cancer, presenting with right breast mass of primary versus secondary origin, progressing into inflammatory breast cancer picture. Our report aims to shed light on the value of early suspicion and low threshold of detecting secondary breast masses of ovarian cancer origin.

Metastasis of serous ovarian carcinoma to the breast: a case report and review of the literature

“…The table provided below summarizes current cases in the existing literature that describe the treatment, time to recurrence, and prognosis of ovarian cancer patients with breast metastases (Table 1 ). 8 cases implemented systemic chemotherapy in their initial treatment of metastatic ovarian carcinoma to the breast, and one case added adjunctive local radiation to their treatment regimen [ 8 ]. Three cases included surgical management in their initial treatment, with two of those cases having surgical management before initiation of chemotherapy for suspected primary breast cancer [ 11 , 12 ] and the other case performing surgery for palliative treatment [ 4 ].…”

“…2020 [ 7 ] 53 2 years Chemotherapy Yes 2 months Local radiation (3500 Gy) Chemotherapy 36 months (death) Abu-Tineh et al . [ 8 ] 54 14 months Chemotherapy Local radiation (3000 cGy) 24 months (ATP) Wang et al . 2020 [ 9 ] 40 6 years Chemotherapy 4 months (LTF)** Antuono et al .…”

“…While there is no consensus regarding a specific treatment regimen for ovarian cancer metastasis to the breast, chemotherapy was the most common treatment modality used in the treatment of breast metastasis and only one case used concurrent local radiation [ 8 ]. Only a small subset of these case reports in the literature includes the use of radiotherapy as the primary treatment of breast metastasis.…”

Metastatic Ovarian Serous Adenocarcinoma Clinically Presenting as Inflammatory Breast Cancer

“…The appearance of the ovarian metastases to the breast can occur concomitantly with the diagnosis, or up to 16 years following diagnosis, with an average time of two years postdiagnosis. In 11-30% of cases, the metastasis is the first manifestation of malignancy, with the patients then surviving being between 13 days and 85 months [ 2 – 5 ]. In the case of our patient, the breast metastasis was identified approximately 570 days after her ovarian cancer diagnosis, and she died 79 days after the initial diagnosis of her ovary to breast metastasis.…”

“…Papillary serous adenocarcinomas are the most frequent ovarian cancers to metastasize to the breast and often present as discreet breast lesions [ 2 – 4 ]. Interestingly, a small subset of these metastases has clinically presented as very rare inflammatory breast cancers, with 12 documented cases [ 5 ]. Here, we report an unusual case of a high-grade ovarian serous adenocarcinoma presenting as inflammatory breast cancer.…”