Carcinoma erysipeloides after breast cancer surgery

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Carcinoma erysipeliodes (CE) is an uncommon type of cutaneous metastasis in which malignant cells spread to the skin via superficial dermal lymphatic vessels. CE constitutes about 1% of breast cancer metastases and is often considered a marker of tumor recurrence, associated with a poor prognosis [1,2].

We present a case of carcinoma erysipeloides in a 44-year-old woman with a three months history of fixed erythematous patches, that was operated of breast cancer one year ago. She was initially being treated for eczematous dermatitis with moderate topical steroids, but without response.

On the physical examination, erythematous macules and plaques were seen over the right breast (submammary), right flank and inguinal region (Figure 1). There was no evident oozing, crusting, or scaling and no nipple retraction on the involved side.

Two punch-biopsies were evaluated from the eczematous areas; they showed emboli of carcinoma cells in the dermal and the subcutaneous blood vessels. In the dermis, there were observed foci of extravascular invasion. Moderate perivascular lympho-mononuclear cell infiltrate was present around many of such vessels containing tumor emboli. We referred the patient to a specialized oncology centre, where she received chemotherapy. After seven months we got the news of her death.

CE represents a diagnostic challenge, and delay in diagnosis is common [3].