case_images: PMC6106907_01
case_images: Aspect of the lesion in the admission of the patient.
case_images: CRIOG2018-4985012.001.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.001.jpg
case_images: fig1
case_images: Hospital with a bulk tumor mass, which extended from the right breast to the right flank, friable, bleeding, and sore with a malodorous (Figure 1). She was undernourished (BMI 15,57/m2), in a regular, state feverish and pale +/4+. Her physical examination performed by medical equipment did not show alterations.
case_images: Chest tomography at the admission.
case_images: CRIOG2018-4985012.002.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.002.jpg
case_images: fig2
case_images: The chest tomography showed the cystic injury and lungs without signs of metastasis (Figure 2).
case_images: Immediate postoperative.
case_images: CRIOG2018-4985012.003.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.003.jpg
case_images: fig3
case_images: After a discussion of the medical board, a hygienic mastectomy, and reconstruction unilateral thoracoabdominal, the surgical specimen performed had the following dimensions: 14,5x12x9 cm and 1.375g (Figure 3).
case_images: Necrosis of the surgical flap (a) and final aspect after debridement (b).
case_images: CRIOG2018-4985012.004.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.004.jpg
case_images: fig4
case_images: Two weeks after the surgical procedure (14  PO), the patient evolved with necrosis in part of the thoracoabdominal flap; it was necessary to perform the debridement of the necrotic area (Figures 4(a) and 4(b)).
case_images: Local recurrence (arrow).
case_images: CRIOG2018-4985012.005.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.005.jpg
case_images: fig5
case_images: Despite the clinical improvement and stability, on the 38  PO clinical staff noted the appearance of ulcerated nodule of around 1 cm of diameter in in the right parasternal region, suggestive of local recurrence, which increased progressively, presenting a measure of around 3 cm at the moment of the patient discharge (Figure 5).
case_images: Chest tomography at the hospital discharge.
case_images: CRIOG2018-4985012.006.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.006.jpg
case_images: fig6
case_images: Besides, during the hospitalization, small pulmonary lesions were identified on computed tomography, absent at the moment of the diagnosis, suggestive of tumor metastasis (Figure 6).
case_images: An aspect of the lesion in the readmission of the patient.
case_images: CRIOG2018-4985012.007.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.007.jpg
case_images: fig7
case_images: Chest tomography in the rehospitalization.
case_images: CRIOG2018-4985012.008.jpg
case_images: PMC6106907_01_CRIOG2018-4985012.008.jpg
case_images: fig8
case_images: A new tomography was performed, presenting pulmonary extensive metastatic lesions, bilateral, besides the massive lesion (Figure 8).