case_images: PMC3540655_01
case_images: (a) The right breast is raised higher than the left breast and demonstrates nipple inversion. (b) Indurated erythema spreads across the right upper breast and upper arm. (c) Indurated erythema across the right upper back. (d) Extensive lymphatic invasion by infiltrative cords of epithelial cells.
case_images: CRIM.DM2012-134938.001.jpg
case_images: PMC3540655_01_CRIM.DM2012-134938.001.jpg
case_images: fig1
case_images: On examination, the right breast was raised higher than the left, the right nipple was inverted, and indurated erythema extended from the upper R breast to the upper arm and back (Figures 1(a), 1(b), and 1(c)). Skin biopsies of the indurated red areas on the chest and arm showed extensive infiltrative cords of epithelioid cells with ductal differentiation and lymphatic invasion, consistent with infiltrative breast carcinoma (Figure 1(d)).
case_images: PMC3540655_02
case_images: (a) Indurated left mastectomy scar with diffuse erythema and purpura. (b) The skin changes extend into the left axilla and back. (c) Groups of cells with pleomorphic nuclei and pale eosinophilic cytoplasm infiltrating dermal collagen. (d) Dermal infiltration by carcinoma.
case_images: CRIM.DM2012-134938.002.jpg
case_images: PMC3540655_02_CRIM.DM2012-134938.002.jpg
case_images: fig2
case_images: On examination, there was diffuse erythema and areas of purpura on the left chest wall extending to the left back, with induration over the mastectomy scar (Figures 2(a) and 2(b)). Further skin biopsies revealed infiltrating adenocarcinoma in the dermis (Figures 2(c) and 2(d)).
case_images: PMC3540655_03
case_images: (a) The right breast displays patchy erythema with purpuric borders. (b) High-grade invasive ductal carcinoma infiltrating dermis, with mitotic figures.
case_images: CRIM.DM2012-134938.003.jpg
case_images: PMC3540655_03_CRIM.DM2012-134938.003.jpg
case_images: fig3
case_images: Four skin biopsies showed widespread infiltration of the dermis by metastatic adenocarcinoma (Figures 3(a) and 3(b)).
case_images: PMC3540655_04
case_images: Focus of dermal lymphatic invasion with a mitotic figure.
case_images: CRIM.DM2012-134938.004.jpg
case_images: PMC3540655_04_CRIM.DM2012-134938.004.jpg
case_images: fig4
case_images: Biopsies from both regions showed infiltration of dermal lymphatics by metastatic ductal carcinoma, which was hormone receptor negative (Figure 4).