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M. S. L. Ho, M. B. Y. Tang, An indurated plaque on the chest and breasts, Clinical and Experimental Dermatology, Volume 33, Issue 5, 1 September 2008, Pages 665–666, https://doi.org/10.1111/j.1365-2230.2007.02561.x
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Extract
Conflict of interest: none declared.
Clinical findings
A 64‐year‐old woman with a history of hypertension, ischaemic heart disease, paroxysmal atrial fibrillation and congestive cardiac failure presented with a 3‐month history of progressive redness and thickening of the chest. She had undergone a coronary artery bypass graft in 2004.
On examination, she was noted to have extensive indurated erythematous thickened skin over both breasts and the thorax, extending to the lateral chest wall and epigastric area (Fig. 1). No ulceration, necrosis or pitting was noted. Verrucous papules and nodules were seen on the lower sternal area (Fig. 2).
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Histopathological findings
A skin biopsy was taken, which showed strands and cords of atypical neoplastic cells between sclerotic collagen bundles. The cells showed ductal structures. Within dilated lymphatics in the upper dermis, there were aggregations of neoplastic cells (Fig. 3).
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Because bilateral pleural effusions were found on clinical examination, a computed tomography scan was obtained, which showed a mass‐like lesion in the right breast with no significant enlarged axillary lymph nodes. Mammography revealed irregular pleomorphic calcifications in the right lower inner quadrant. A core biopsy showed invasive ductal carcinoma.
