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Case of the Month

July 2009

Patient Data: 57 year old female patient

Clinical Info: Palpable mass lesions in the breast, and upper arm


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Lesion in the right breast with an inhomogeneous structure


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Image of the same breast lesion


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Color Doppler shows some internal vascularity


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Longitudinal ultrasound image of the palpable mass in the upper arm. The lesion shows an ultrasound appearance similar to the lesion in the breast.


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Transverse ultrasound image of the palpable mass in the upper arm. The lesion shows an ultrasound appearance similar to the lesion in the breast.


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Color Doppler image of the same lesion in the upper arm with only some peripheral vascularity


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A third lesion was encountered in the right axilla. An ultrasound guided biopsy was performed of all three lesions. The biopsy specimens were much darker than usual.

All three lesions proved to be melanoma. The patient had no previous history of a melanoma and no signs of a cutaneous melanoma was found.
Malignant melanoma is the most rapidly increasing cancer in the world. Metastatic disease occurs in 20% of patients. Metastases to the breast are rare. Melanoma is, however, among the most commonly reported primary tumors to metastasize to the breast. With the increasing incidence of melanoma, this complication is being encountered with greater frequency.

For more examples of breast metastases see

References
Ravdel L, Robinson WA, Lewis K, Gonzalez R. Metastatic melanoma in the breast: a report of 27 cases.
J Surg Oncol. 2006 Aug 1;94(2):101-4.

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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