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This case report aims to raise awareness of metastatic malignant tumor in the breast as the initial presentation of the occult non-mammary primary tumor. Embarking on radical surgical treatment for such metastatic tumors on the assumption of primary breast malignancy would have grave consequences for the patient and results in delayed treatment of the primary extra-mammary malignancy. The distinction is easier in patients with previously known malignancy in the contralateral breast or non-mammary malignancy. There are no consensuses about clinical, radiological, and histological features to distinguish primary from metastatic breast neoplasm due to the rarity of the condition. The case below is a young woman with a diagnosis of diffuse-signet ring cell gastric cancer. The first presentation was in form of rapid diffuse painless swelling of the right breast accompanied by abdominal distention, with the finding of ascites, peritoneal nodules, and enlarged enhancing ovaries on imaging. Biopsy from multiple sites confirmed involvement by metastatic adenocarcinoma with signet ring pattern. Her condition progressed after the 5th cycle of EOX.
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Nidhamalddin et al. (2020) studied this question.
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