Ulcerated breast cancer with single brain metastasis: A combined surgical approach. Clinical presentation at one year follow up – A case report. (2020)

• Record Type: Journal Article
• Authors: Santori, Francesca; Vanni, Gianluca; Buonomo, Oreste Claudio; De Majo, Adriano; Rho, Maurizio; Granai, Alessandra Vittoria; Pellicciaro, Marco; Cotesta, Maria; Assogna, Massimo; D'Angelillo, Rolando Maria; Materazzo, Marco
• Is Part Of: International journal of surgery case reports. Volume 73(2020)
• Page Start: 75
• Page End: 78
• Publication Date: 2020
• Subjects: BC breast cancer -- BCIV breast cancer de novo stage IV -- PTR primary tumour resection -- B-MRI brain magnetic resonance imaging -- PET-CT positron emission tomography-computerized tomography -- BR breast reconstruction -- WBRT whole brain radiation therapy -- EBRT external beam radiation therapy -- SRS stereotaxis radiosurgery; Breast cancer -- Brain metastasis -- Breast reconstruction -- Metastasectomy -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.06.074
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Solitary brain metastasis of breast cancer in a patient with neurological symptoms as first presentation is a rare complication. Simultaneously perform a metastasectomy surgery plus right mastectomy, right axillary dissection and immediate breast reconstruction is unusual event. Successful combined surgical approach in a stage IV de novo breast cancer patient with single site brain metastasis at one year follow-up. Combined surgical approach offers the opportunity to treat two different oncological urgencies, reducing the unnecessary repeated surgical and anesthesiologic trauma. Abstract: Introduction: Breast cancer is the most common malignancy in woman. Approximately 5–10% of breast cancer occurs as de novo stage IV and some studies have shown that from 10% to 30% of those patients presents Brain Metastasis. Presentation of case: In this study, we report a case of solitary brain metastasis of breast cancer in a 63-year-old Italian Caucasian woman with neurological symptoms as first clinical presentation. After the correct diagnosis and multidisciplinary meeting it was decided to simultaneously perform a metastasectomy surgery plus right mastectomy, right axillary dissection and immediate breast reconstruction. In our clinical practice we report a successful combined surgical approach in a stage IV de novo breast cancer patient with single site brain metastasis at one year follow-up. Discussion: Metastasectomy plus mastectomy provided neurological control of acute complication of metastatic disease and complete breast cancer local control. One-time operation could be the best option when diagnosis of breast cancer is made thanks to the onset of oncological emergency like intracranial hypertension due to single brain metastasis. Conclusion: Combined surgical approach offers the opportunity to treat two different oncological urgencies, reducing the unnecessary repeated surgical and anesthesiologic trauma.