TITLE:
Advanced Papillary Carcinoma of the Breast Presenting as an Ulcerated Anterior Chest Wall Tumour: Case Report
AUTHORS:
U. Abubakar, J. N. Legbo, S. M. Sahabi, C. Opara, I. R. Jamalu, N. Musa, S. Aliyu
KEYWORDS:
Advanced Papillary Carcinoma; Chest Wall Tumour; Breast Carcinoma; Ulcerated Tumour
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.3 No.1,
January
7,
2014
ABSTRACT: BACKGROUND: Papillary carcinoma of the breast is a rare malignant
tumour accounting for 1% - 2% of all breast cancers in women. Papillary carcinomas of the chest wall
are always secondary to thyroid, thymus and ovaries. Other variants of breast cancer metastasizing to
the chest wall have been reported. CASE: We report a 67-year-old woman presented to us with an ulcerated
anterior chest wall mass of 1-year
duration, bilateral axillary, supraclavicular and cervical swellings of 8-month duration. There was a history of breast lump which was noticed 5
years prior to presentation, no
history of breast malignancy in the past and no family history of breast
cancer. Examination revealed an ulcerated, nodular mass over the sternal angle
which measured 14 cm × 12 cm × 4 cm; she had bilateral axillary, supraclavicular and cervical
lymphadenopathy which were non-tender and matted. She had a firm, non-tender
right breast lump measuring 6 cm × 4 cm. Chest
examination and abdominal examinations were essentially normal. Chest X-ray
revealed erosion of sternal bone without any evidence of intrathoracic
extension. Abdominal ultrasound and thyroid scans were normal. Histology of the
mass revealed papillary carcinoma. Biopsy of the right breast also revealed
papillary carcinoma. She had excision of the fungating tumour and primary closure
of defect. She subsequently had combination chemotherapy using ondasetron, cyclophosphamide,
adriamycin and cisplantin. CONCLUSION: Papillary carcinoma of the breast is rare and rarely metastasizes to
the chest wall. The diagnosis of metastatic
chest wall tumour requires meticulous history taking, clinical examination and
relevant investigations to ascertain the primary origin of the carcinoma.