Oligometastatic Breast Cancer With Cutaneous Involvement and Paraneoplastic Hypercalcemia in a Young Woman

TL;DR

A young woman with aggressive breast cancer and skin involvement showed improvement with combined treatment, highlighting the need for quick, coordinated care.

Contribution

This case report highlights a rare presentation of breast cancer with cutaneous involvement and paraneoplastic hypercalcemia in a young woman.

Findings

The patient showed significant clinical and radiologic response to neoadjuvant chemotherapy.

Hypercalcemia resolved following treatment, and the patient remained disease-free at 24 months post-surgery.

Abstract

Cutaneous involvement in breast cancer is typically associated with locally advanced or neglected disease. In young women, such presentations are often associated with a more aggressive biological behavior.

We report the case of a woman in her early 40s presenting with a large, cutaneous-involved, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, right breast cancer with neuroendocrine differentiation. Imaging revealed axillary, supraclavicular, and right cervical lymph node involvement, with no evidence of distant metastasis. Laboratory evaluation at diagnosis demonstrated malignant hypercalcemia refractory to medical treatment. The patient received neoadjuvant chemotherapy, achieving resolution of hypercalcemia and a significant clinical and radiologic response, followed by surgery, radiotherapy, and adjuvant endocrine therapy. At 24 months post-surgery, the patient remains free of disease.

This case underscores the importance of prompt multidisciplinary management in aggressive presentations of breast cancer, even when associated with paraneoplastic syndromes.

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