ABSTRACT
Breast metastases from extramammary primary tumors are uncommon, accounting for approximately 1.3~6.6% of all malignant mammary tumors. Apart from hematopoietic neoplasms, malignant melanoma is one of the most common neoplasms with which secondary involvement of the mammary parenchyme is known. Although they are so rare, breast metastases from such neoplasms can mimic primary breast carcinoma clinically and on imaging studies. Approximately 20% of the patients affected by malignant melanoma will develop metastases, the commonest sites being liver, lung, and brain; metastases to the breast from malignant melanoma are rare, and in about 40% of the patients affected the breast lesion is the first manifestation of disease. Correct management of metastatic disease to the breast can prevent unnecessary mutilation; in fact, in the majority of patients so far widespread metastases have appeared rapidly despite various systemic treatments, showing that major surgery gives very poor results in terms of controlling the disease. In this paper, we present the case of a 49-year-old woman with a history of a malignant cutaneous melanoma of nasal cavity that had been surgically excised in 2004. She was admitted to our Breast Division 6 months later because a screening mammogram and anultrasound evaluation had revealed the presence of a nodular opacity in the both breast, without any clinical manifestations. For this reason, in September 2004 the patient underwent a simple mastectomy of both breasts.