Isolated inguinal lymph node metastasis from breast carcinoma--case report and review of the literature.

We report on a case of a premenopausal woman with breast cancer and unusual dissemination with isolated inguinal and iliac lymph node metastasis. The primary tumor was T2N0M0. After mastectomy the patient received adjuvant chemotherpy, hormonotherapy and radiotherapy (RT). Painful edema developed at the right leg 69 months after the operation. Diagnostic investigations revealed isolated right inguinal and iliac lymphadenopathy (LAP). Tru-cut aspiration biopsy was reported as negative. Four months later, abdominal magnetic resonance imaging (MRI) disclosed paraaortic and bilateral iliac and inguinal LAP. Pathological assessment of the right inguinal LAP confirmed a metastasis from breast cancer. After unsuccesful chemotherapy, palliative RT was performed to the inguinal, iliac and paraaortic lymph nodes, resulting in partial response. The patient ultimately died because of disease progression. Clinicians should maintain a high degree of suspicion when coming across with unusual complaints and findings in patients with breast cancer.