Solitary scalp metastatic lesion as a sign of breast cancer recurrence—a case report

Scalp tumors are rare and account only for 2%. Nevertheless, the scalp region accounts for 4–6.9% of all cutaneous metastases. Metastatic cutaneous lesions are more often found in women with breast cancer than in those with other internal malignancies.

Case report.

A 59-year-old woman, who had been clinically diagnosed with stage-IIIA (T₃ N_2a M₀) invasive ductal right breast carcinoma in August 2015, was treated by neoadjuvant chemotherapy with good partial response. Breast conservative surgery was done and she received post-operative adjuvant radiotherapy and hormonal treatment with letrozole. Two years later, the patient noticed a slowly growing, painless scalp nodule. A PET-CT scan was performed and demonstrated scalp mass at the left temporal region. Excisional biopsy was performed; histopathologic examination revealed poorly differentiated adenocarcinoma. In addition, detailed immunohistochemical staining was performed. Accordingly, patient was given radiotherapy and second line hormonal treatment was added, with disease-free survival of one year.

Despite its rarity, solitary scalp metastasis should be considered in the differential diagnosis in patients with a history of cancer especially breast cancer.