Epidermoid carcinoma of the skin mimicking breast\ncancer
A 55-year-old female patient presented a lesion on the right breast for two years and\nstated that initially it was only a small sore that did not heal. The lesion enlarged\nslowly during the two following years and rapidly in the past three months. At first,\nthe patient did not seek medical attention because of hesitation. When she presented to\nthe department, she had already undergone a biopsy of the lesion which revealed an\nundifferentiated carcinoma. Subsequently a mastectomy was planned, as it was considered\nas a breast cancer case. On physical examination, a large 15x10cm ulcerated lesion was\nobserved on the right breast, extending from the upper portion of the junction of the\nupper quadrants to an area near the right clavicle, without evidence of invasion of the\nbreast parenchyma ( and ). The axilla and the supraclavicular fossa had no\nsuspected lymph nodes. Because of the clinical history, a diagnosis of breast skin\ncarcinoma was considered, which was confirmed by a histopathological examination\nrevealing epidermoid carcinoma T4N2M0. Chest radiography and abdominal ultrasound were\nunremarkable. Afterwards, a wide excision of the lesion with a 2cm margin was performed.\nA defect at the surgical field was left open for subsequent tissue grafting because of\nan infection observed intraoperatively. She had a good immediate postoperative course,\nand the skin grafting was scheduled. The definitive histopathological examination\nconfirmed a moderately differentiated epidermoid carcinoma with free surgical margins.\nSix months later, she presented with a defective, but complete cicatrization. Currently,\nfive years after surgery, she remains without evidence of ongoing disease.