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Description
Cancer or carcinoma en cuirasse is an infrequent clinical presentation of metastatic cutaneous carcinoma.1 In this condition, the skin of the chest wall is studded with carcinomatous indurated plaques. It is often seen after a patient of breast cancer undergoes mastectomy operation and develops local recurrence. The patient usually presents after a few months or years after the surgery2 (figure 1). This patient, a 22-year-old woman, had already undergone right modified radical mastectomy for infiltrating ductal carcinoma (IDC) Not Otherwise Specified (NOS) grade II with triple-negative receptor status, 1 year ago. She had now presented with a lump in the left breast and multiple cutaneous lesions on the chest wall on the right side and on the left breast since the past 5 months (figure 2). Cutaneous metastasis or carcinoma en cuirasse has occurred on the right side after mastectomy, whereas they are a part of the initial presenting symptom on the contralateral side. The patient also had multiple fixed right axillary lymph nodes and a left supraclavicular node; both came positive for malignancy. Core needle biopsy was suggestive of IDC NOS grade II with Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth factor receptor 2 (HER2/neu) negative status. Only one cycle of docetaxel injection and oral capecitabine was given by the medical oncologist as palliative therapy, at the time of writing this case. However, electrochemotherapy is an impressive modality of palliative treatment of cutaneous metastasis in the recurrence of carcinoma breast after undergoing surgery and radiation therapy.3 Unfortunately, this therapy was not available at our centre.
Cutaneous metastasis (cancer en cuirasse) after right modified radical mastectomy.
Left breast showing cutaneous metastatic nodules with inversion of nipple.
Learning points
Carcinoma en cuirasse, along with a breast lump, can be a presenting symptom in carcinoma breast as well as present as local recurrence on the mastectomy site.
Carcinoma en cuirasse can also be seen in young patients with an aggressive primary tumour.
Footnotes
Contributors All the authors have contributed to the conception or design of the work, the acquisition, analysis and interpretation of data. They have drafted the work, revised it critically for important intellectual content. They have given the final approval of the version published. They agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.