Solitary peritoneal metastases from ductal breast cancer

Breast carcinoma remains the most common malignancy in women in western countries. The principal sites of metastases are the regional lymph nodes, liver, lung and bone; unusual sites of metastases are very rare. Infiltrating ductal carcinoma is the most common histological subtype (about 80%) as compared to lobular carcinoma (7-20%), which metastasizes more frequently to unusual sites. An 80-year-old female patient was submitted to resection of an infiltrating ductal carcinoma (stage I). After 4 years, the presence of a pelvic mass in the absence of local, distant or lymph node recurrence was found. Resection of the mass was performed. The pathological and immunohistochemical examination revealed a metastatic carcinoma compatible with a mammalian origin. After 36 months of follow-up the patient is alive and disease-free. Considering the age of the patient, the good performance status, the absence of other sites of relapse and the large size of the mass, surgery was performed. Surgery remains the only valid option when recurrence produces abdominal complications. In the absence of randomized prospective studies, however, we do not know whether this is always the correct therapeutic strategy.