CASE REPORT article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1535421
Advanced breast invasive ductal carcinoma with erysipeloid cutaneous metastasis misdiagnosed as erysipelas: A case report
Provisionally accepted
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Breast cancer ranks as the second most prevalent malignancy globally, surpassed only by lung cancer in incidence. Clinically, breast cancer patients may initially present with cutaneous manifestations of breast pathology. However, erysipeloid carcinoma typically emerges as a delayed presentation following primary breast cancer diagnosis and treatment, thereby significantly elevating the risk of diagnostic inaccuracy.The patient was a 51-year-old female with a history of left breast carcinoma (HER2-positive type, pT2N3M0, stage IIIC; primary tumor dimensions 4.6 cm × 4.5 cm × 1.6 cm, with 14 of 21 axillary lymph nodes involved), for which she underwent modified radical mastectomy on April 21, 2021.Three years postoperatively (April 2024), the patient presented with erythema, edema, and localized hyperthermia of the left upper limb, initially misdiagnosed as erysipelas. Following one week of antibiotic therapy, the inflammatory manifestations showed mild regression.In May 2024, the patient developed unexplained cephalalgia and vertigo. Contrast-enhanced cranial magnetic resonance imaging (MRI) demonstrated multiple metastatic brain lesions with suspected left cervical lymph node metastasis, prompting initiation of whole-brain radiotherapy. During radiotherapy, the patient manifested erysipeloid cutaneous eruptions involving the left thoracic wall, ipsilateral upper extremity, and contralateral breast.Histopathological examination of the thoracic wall lesion in June 2024 confirmed cutaneous metastasis. Subsequent systemic antitumor therapy resulted in significant regression of both cutaneous and cerebral metastatic lesions.The imperative for histopathological confirmation via biopsy cannot be overstated when breast cancer patients present with localized cutaneous eruptions. Distinctive inflammatory patterns associated with cutaneous metastases necessitate prompt recognition by breast oncology specialists, as early diagnostic intervention directly correlates with therapeutic efficacy and improved overall survival outcomes.
Keywords: breast carcinoma, Cutaneous metastasis, Erysipeloid, Pathology, Immunohistochemistry
Received: 27 Nov 2024; Accepted: 20 Jun 2025.
Copyright: © 2025 Gu, Yuan, Dong, Sheng and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jiayu Sheng, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Ke Jiang, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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