Cancer en cuirasse C80.x3

A form of extensivecutaneous metastasis (lymphangiosis carcinomatosa) characterized by plaque-like, often dark red induration of the skin due to intracutaneous (through tissue gaps) and lymphogenous dissemination of tumor cells, with consequent fibrosis and edema formation (see also erysipelas carcinomatosum). Most commonly seen in breast cancer, sometimes involving encasement of the entire chest wall. 

The goal of treatment is to maintain the highest possible quality of life despite an unfavorable prognosis. Radiation therapy or chemotherapy may be used. The treatment plan depends on the extent of the metastases and the primary tumor.

Specialized treatment at a breast cancer center. 

Specialized treatment at a breast cancer center (see case report).   

A patient in her seventies with a history of ductal carcinoma in situ of the left breast following radiation therapy and lumpectomy presented with skin thickening on the left breast and several firm lumps in both breasts. The biopsy revealed an invasive ductal carcinoma of the left breast (estrogen receptor [ER]/progesterone receptor [PR]-positive, human epidermal growth factor receptor-2 [HER2]-negative) as well as ductal carcinoma in situ of the right breast (ER/PR-positive).

She subsequently underwent a right-sided lymphectomy; however, the left-sided mastectomy was discontinued due to a deterioration in the skin findings during the preoperative examination. A skin biopsy revealed a poorly differentiated invasive ductal carcinoma. She was diagnosed with stage 4 breast cancer (carcinoma en cuirasse). Systemic therapy was initiated, followed by a mastectomy of the left breast. A surgical biopsy revealed a HER2-positive result, prompting the initiation of anti-HER2 therapy. The patient remains on maintenance therapy and is showing an excellent response. Thanks to continuous advances in treatment, newer therapeutic options are now available even for widely metastatic forms of breast cancer (Godbole M et al. 2023).

1. Godbole M et al. (2023) Carcinoma En Cuirasse: A Rare but Striking Cutaneous Manifestation of Metastatic Breast Cancer. Cureus 15:e39838.

2. Nozu S et al. (2022) Lung cancer that recurred as carcinoma en cuirasse. Respirol Case Rep 10:e01041.

3. Sindermann H et al. (1995) Miltefosine Solution: Prognostic factors for the outcome of topical treatment of skin metastatic breast cancer. Onkologie 17: 21–26
4. Oldenborg S et al. (2018) Reirradiation + hyperthermia for recurrent breast cancer en cuirasse. Strahlenther Onkol;194: 206–214
5. Sengedorj A et al. (2022) The Effect of Hyperthermia and Radiotherapy Sequence on Cancer Cell Death and the Immune Phenotype of Breast Cancer Cells. Cancers (Basel). 19;14:2050.