Dados do Trabalho

Título

CARCINOMA DE CELULAS ESCAMOSAS METASTATICO PARA MAMA: RELATO DE CASO

Título em Inglês

SQUAMOUS CELL CARCINOMA METASTASIS FOR MAMMARY GLAND: CASE REPORT

Introdução

Primary squamous cell carcinoma (SCC) of the breast is a rare neoplasm, which represents less than 0.1% of invasive breast cancers. Therefore, it is essential to discriminate between a primary SCC and a metastatic SCC. In order to be considered primary of the breast, in the histological examination of the lesion there must be more than 90% of squamous neoplastic cells, in addition to the absence of cutaneous SCC or other anatomical sites. Extra-mammary neoplasm metastases are uncommon, representing 0.5 to 2% of breast malignancies. Metastatic SCC in the mammary gland is an uncommon event. To date, there are only 3 cases reported in literature of secondary involvement of vulvar SCC in the mammary gland. The objective of this work is to report the case of a patient with secondary mammary metastasis to a vulva SCC.

Relato de caso

A 74-year-old female patient who underwent radical modified vulvectomy 10 years ago. The pathological stage was characterized as IIIB. For this reason, she was also submitted to adjuvant treatment with chemotherapy associated with radiotherapy to the vulvar region, inguinal lymph node chains and pelvic arteries. On the ninth year of cancer follow-up, she had recurrence in the vaginal wall. In the complementary image exams, the extent of neoplasia to pelvic organs were identified, but no distant metastatic lesions were found. She underwent monobloc resection of pelvic organs, with reconstruction of urinary and intestinal transit. The patient showed a good clinical evolution, with no pelvic complaints. After one year, the patient returned with a complaint of a nodule in the right breast. On physical examination, a lesion was observed at the junction of the lateral quadrants of the breast, measuring +/- 3.5 cm, with associated inflammatory signs and imprecise limits, with a central region showing a fistulous orifice through which the necrotic material passed (Figure 1). On the mammography, a dense, rounded and partially delimited lesion was identified. She underwent a core biopsy that described a SCC. According to previous clinical history, it was considered a remote relapse of the vulvar SCC. The patient was submitted to a quadrantectomy with an ipsilateral axillary lymphadenectomy and reconstruction with a lateral thoracic flap (Figure 2). In the anatomopathological examination there was a description that the neoplasm would invade the underlying muscle tissue; and the resection margins were free. Four, of the fourteen isolated axillary lymph nodes had metastases, without perinodal soft tissue invasion. Six months after breast surgery, the patient evolved metastases to both lungs and soon after died without response to the systemic treatment employed. This report was approved by the Research Ethics - UFFS (number 4.034.565).

Palavras Chave

Squamous cell carcinoma; Breast cancer; Local Neoplasm Recurrence; Neoplasm Metastasis.

Área

DETECTION / DIAGNOSIS - Breast lesion