Kelati Awatef, Gallouj Salim
Department of Dermatology, University Hospital of Fez, Fez, Morocco.
J Med Case Rep. 2018 Sep 22;12(1):273. doi: 10.1186/s13256-018-1803-z.
Cutaneous metastatic breast cancer is the most common cutaneous metastatic malignancy in women. The assessment of cutaneous metastatic disease can be perplexing because the clinical presentation appears similar to other skin malignancies like angiosarcoma or melanoma, or benign diseases like cellulitis and lymphedema. To date, only a limited number of dermoscopic images of cutaneous metastatic solid tumors, especially breast cancer, have been published.
The authors report two Moroccan cases highlighting dermoscopy as a quick tool to recognize skin metastasis of breast cancer in two different clinical presentations. A 51-year-old Moroccan woman presented with nodules of various sizes on and around a mastectomy scar, and a 65-year-old Moroccan woman presented with cellulitis-like lesions on her chest wall and her back. Dermoscopic features were similar in the two cases with findings of yellow central areas, polymorphic vessels, whitish bright lines, whitish structureless areas, and linear irregular fissure-like depressions on a pink-orange background.
The recognition of dermoscopic patterns of cutaneous metastasis of breast cancer is not only useful to facilitate diagnosis at an early stage and to rule out other differentials, especially in difficult presentations such as cellulitis-like lesions or lymphedema, but it may also be used by physicians in monitoring mastectomy scars.
皮肤转移性乳腺癌是女性中最常见的皮肤转移性恶性肿瘤。皮肤转移性疾病的评估可能令人困惑，因为其临床表现与其他皮肤恶性肿瘤如血管肉瘤或黑色素瘤，或与蜂窝织炎和淋巴水肿等良性疾病相似。迄今为止，仅有数量有限的皮肤转移性实体瘤（尤其是乳腺癌）的皮肤镜图像被发表。
作者报告了两例摩洛哥病例，突出了皮肤镜作为一种快速工具，可在两种不同临床表现中识别乳腺癌皮肤转移。一名51岁的摩洛哥女性在乳房切除术后瘢痕及其周围出现大小各异的结节，一名65岁的摩洛哥女性在其胸壁和背部出现蜂窝织炎样病变。两例病例的皮肤镜特征相似，表现为在橙粉色背景上有黄色中央区域、多形性血管、白色亮线、白色无结构区域以及线性不规则裂缝样凹陷。
识别乳腺癌皮肤转移的皮肤镜模式不仅有助于早期诊断并排除其他鉴别诊断，尤其是在蜂窝织炎样病变或淋巴水肿等困难表现中，而且医生在监测乳房切除术后瘢痕时也可使用。
