Diffuse cutaneous breast cancer metastases resembling subcutaneous nodules with no surface changes

Cutaneous metastases typically occur in only a small minority of breast cancer patients. Clinical appearance can vary, but lesions often present as isolated dermal nodules with superficial discoloration or a change in texture on the chest ipsilateral to the primary breast malignancy. We report the case of a woman with metastatic adenocarcinoma of the breast presenting with diffuse cutaneous nodules with no surface changes. The nodules were almost undetectable clinically and had minimal elevation, making them difficult to detect, especially without palpation. A punch biopsy showed positive cytokeratin immunostaining consistent with the markers for the primary breast cancer. A review of the literature on cutaneous metastases from breast adenocarcinomas also is provided.