OVARIAN METASTATIC ADENOCARCINOMA OCCURRING AS BILATERAL AXILLARY METASTASES ASSOCIATED WITH MASTITIS

A 59-year-old patient with an ovarian metastatic adenocarcinoma, prese nting as bilateral axillary metastases associated with mastitis, under went extensive primary abdominal cytoreductive surgery and bilateral a xillary lymphadenectomy. Neoplastic axillary lymph node involvement an d mastitis raised the issue of the clinical differential diagnosis bet ween a primary breast cancer and a metastatic cancer. Preoperative cli nical and radiologic investigation did not absolutely exclude the pres ence of a primary breast cancer, although the elevated serum CA 125 le vel (1024 UI/ml) suggested a possible primitive ovarian cancer. Pathol ogic examination of surgical material supported the ovarian origin of the adenocarcinoma, a poorly differentiated papillary serous type. The mammary erythematosus cutaneous changes were interpreted as effects o f axillary lymphatic neoplastic block. In fact, after the last chemoth erapy course, the breast healed without sequelae. Because the clinical presentation of metastases to the breast or axillary lymph nodes or b oth may strongly mimic primary breast cancer, their clinicopathologic recognition is crucial in planning appropriate treatment and follow-up .