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Annales de Dermatologie et de Vénéréologie
Vol 130, N° 6-7  - juin 2003
pp. 623-625
Doi : AD-06-2003-130-6-0151-9638-101019-ART6
Métastase mammaire d'un adénocarcinome ovarien
 

J. Martel [1], J.-J. Roux [1], I. Treilleux [2], P. Bouchet [1], X. Froger [1], I. Mechin-Cretinon [1]
[1]  Unité de Dermatologie, Centre Hospitalier de Chambéry
[2]  Département d'Anatomie et de Cytologie Pathologiques, Centre Léon Bérard, Lyon.

Tirés à part : J. MARTEL [1]

[1]  Unité de Dermatologie, Centre Hospitalier de Chambéry, BP 1125, 73011 Chambéry Cedex. E-mail :

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Introduction

Les métastases mammaires sont rares. Les tumeurs primitives sont cutanées, pulmonaires, digestives et prostatiques. Une tumeur maligne de l'ovaire est rarement en cause.

Observation

Chez une femme de 69 ans apparaissait, 3 ans après la découverte d'un adénocarcinome ovarien, une mastite importante unilatérale dans un contexte polymétastatique. L'examen anatomopathologique permettait d'affirmer l'origine ovarienne des nodules mammaires observés. L'évolution était péjorative et la malade décédait 8 mois après les premiers signes cliniques mammaires.

Commentaires

La difficulté de différencier une mastite carcinomateuse primitive d'une mastite d'origine secondaire est grande si le cancer primitif est inconnu. Dans notre cas, l'étude immunohistochimique n'était pas discriminante entre une origine mammaire et une origine ovarienne. Le diagnostic a été finalement posé sur les bases de l'histologie standard et sur la corrélation anatomoclinique. La confrontation anatomoclinique est primordiale, puisque les examens immunohistochimiques peuvent être pris en défaut comme dans notre observation.

Abstract
Breast metastases of an ovarian adenocarcinoma.
Introduction

Breast metastases are rare. Primary tumors are cutaneous, pulmonary, digestive and prostatic. A malignant tumor of the ovary is rarely responsible.

Observation

A 69 year-old women presented a voluminous unilateral mastitis in a poly-metastatic context 3 years after the discovery of an ovarian adenocarcinoma. The anatomo-pathological examination confirmed the ovarian origin of the breast nodules observed.

Progression was poor and the patient died 8 months after the first clinical signs in the breast.

Comments

The difficulty in differentiating a primary from a secondary carcinomatous mastitis is enhanced when the primary cancer is unknown. In our patient, the immunohistochemical study did not discriminate between the breast and ovarian origin. The diagnosis was finally made on the basis of standard histology and the anatomoclinical correlation. Since immunohistochemical examinations may not be specific enough, such as was the case in our patient, the anatomoclinical confrontation is essential.






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