State University of Piauí, Teresina, PI, Brazil.
Oncocenter, Teresina, PI, Brazil.
Pan Afr Med J. 2021 Sep 8;40:23. doi: 10.11604/pamj.2021.40.23.31009. eCollection 2021.
Occult breast cancer (OBC) is characterized by metastatic presentation of undetectable breast tumor on imaging exams. OBC is a rare disease (accounting for 0.3% to 1.0% of all breast cancers) that represents a major diagnostic challenge. The aim of this study was to report a case of OBC with primary presentation of multiple cutaneous metastases with subsequent emergence of bone metastasis. A 70-year female patient had multiple cutaneous metastatic lesions in the left cervical region, left breast, left axillary region, left subscapular region, in three chirodactylus of the right hand and three chirodactylus of the left hand. Imaging tests (mammogram, ultrasonography and magnetic resonance imaging of the breast) did not show alterations. Biopsy, histology sections and immunohistochemistry of the left cervical cutaneous lesion were compatible with OBC. After two years of anastrozole treatment (1mg/day), there was regression of all cutaneous lesions and stabilization of bone metastasis. OBC has a better prognosis. It may exhibit spontaneous regression or respond to less aggressive treatment strategies, as described in this case.
隐匿性乳腺癌（OBC）的特征是影像学检查无法检测到乳房肿瘤的转移表现。OBC 是一种罕见疾病（占所有乳腺癌的 0.3%至 1.0%），具有很大的诊断挑战性。本研究的目的是报告一例 OBC 患者，其主要表现为多发性皮肤转移，随后出现骨转移。一名 70 岁女性患者的左侧颈部、左侧乳房、左侧腋窝、左侧肩胛下区域、右手三个蹼状指和左手三个蹼状指出现多处皮肤转移性病变。影像学检查（乳房 X 光、超声和乳房磁共振成像）未显示异常。左侧颈部皮肤病变的活检、组织学切片和免疫组织化学检查符合 OBC。在接受阿那曲唑（1mg/天）治疗两年后，所有皮肤病变均消退，骨转移稳定。OBC 具有较好的预后。正如本例所示，OBC 可能会自发消退或对侵袭性较低的治疗策略有反应。
