1. Department of Surgery, Section of Surgical Oncology, The University of Arizona Cancer Center Tucson, Arizona, USA;
2. Department of Radiology, The University of Arizona Cancer Center Tucson, Arizona, USA;
3. Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, The University of Arizona Cancer Center Tucson, Arizona, USA;
4. Department of Pathology, The University of Arizona Cancer Center Tucson, Arizona, USA.
Background. Primary ovarian carcinoma with metastasis to the breast is rare, with only 39 cases reported in the current literature. Ovarian metastasis to the breast presenting as inflammatory breast carcinoma is even more infrequent, with only 6 cases reported.
Case. We present a patient who developed metastatic inflammatory cancer of the breast from a stage IIIC papillary serous ovarian adenocarcinoma approximately 1 year after the original diagnosis. Pathologic analysis confirmed the origin of the tumor: a high-grade adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. In addition, the tumor was strongly positive on immunohistochemistry for CA-125, identical to the ovarian primary. The patient died of diffuse metastasis 5 months after the breast tumor was noted.
Conclusion. Although ovarian metastasis to the breast presenting as inflammatory breast cancer is rare, it should be included in the differential diagnosis for any patient with a personal history of ovarian cancer. Accurate differentiation is necessary because treatment differs significantly for patients with ovarian metastasis to the breast, as compared with patients with primary inflammatory breast cancer. Ovarian metastasis to the breast confers a poor prognosis: patient survival ranged from 3 to 18 months, with a median survival of 6 months after the diagnosis of the breast metastasis.
Keywords: breast cancer, ovarian cancer, inflammatory breast cancer, ovarian cancer metastasis, breast cancer metastasis