Metastatic carcinoma in axillary lymph nodes without pathologic evidence of a primary mammary lesion: a case report.

A 56-year-old nullipara presented with a mass in the right axilla. Pathologically, two enlarged lymph nodes were found to contain metastatic adenocarcinoma consistent with a primary from the breast. Clinically, no breast mass was palpable, and xeromammography showed diffuse ductal hyperplasia and a small focus suggestive of malignancy. Modified radical mastectomy was done, and no tumor was found pathologically in the excised breast. The patient received local radiotherapy and is alive and well one year postoperatively. Attention is drawn to this rare occurrence, and patient management is briefly discussed.