Think Beyond Recurrence-Unexpected Diagnosis at a Rare Site

Area of Science:

• Oncology
• Dermatopathology

Background:

• Primary squamous cell carcinoma of the breast is rare (<0.1%), aggressive, and hormone receptor-negative.
• Verrucous carcinoma, a low-grade variant, typically affects skin/mucosa with slow growth and good prognosis.
• This variant is uncommon in the breast/chest wall region.

Purpose of the Study:

• To report a unique case of verrucous carcinoma on the chest wall.
• To highlight diagnostic challenges in differentiating from breast cancer recurrence.
• To discuss the presentation and management of this rare entity.

Main Methods:

• Case presentation of a patient with a history of breast carcinoma post-mastectomy.
• Clinical and histopathological examination of the chest wall lesion.
• Differential diagnosis considerations including local recurrence.

Main Results:

• A diagnosis of verrucous carcinoma of the chest wall was established.
• The lesion was initially suspected to be a local recurrence of breast cancer.
• The case highlights an unusual presentation and location for verrucous carcinoma.

Conclusions:

• Verrucous carcinoma can occur in rare locations like the chest wall, posing diagnostic difficulties.
• Distinguishing this benign variant from aggressive local recurrence is crucial for appropriate management.
• This case underscores the importance of thorough histopathological evaluation for uncommon presentations.