RESUMO
Introduction: Breast Squamous Cell Carcinoma (SCC) is quite a rare tumour that the features portray squamous cell differentiation. Presentation of case: We report a case of a 56-year-old female presented left breast lump that had been increasing in size for a 7 months duration associated with nipple retraction for one week. Ultrasound breast was done and revealed a large mixed echo density mass lesion in the left breast at 12 o'clock, 2cm from the nipple and measuring 4.2 × 3.4cm along with an enlarged node in the left axilla with thickened cortex and as for Mammogram revealed suspicious left breast lesion with enlarged axillary nodes, BIRADS 5. Histopathology from the left breast showed Invasive carcinoma with squamous differentiation, B5b, ER: negative, PR: Positive, Her2: Negative, CK5/6: Positive. Then a staging CECT Thorax, Abdomen and Pelvis was done which showed enhancing mass lesion seen at the left breast (4.1 × 4.3cm) with areas of necrosis within and multiple enlarged left axillary nodes seen with no local infiltration to the muscle or skin as well as no distant metastases. Patient underwent Neoadjuvant chemotherapy for 6 cycles and completed them. Discussion: This case highlights the crucial need of early detection along with the obstacles faced in reaching an early diagnosis tagged with the lack of guideline to manage this patient. Conclusion: In the management of Breast Squamous Cell Carcinoma, the standard treatment would be to go for mastectomy with axillary clearance. However, the prognosis usually depends on the tumour size and the advance age of the patient as described in this article.
RESUMO
Introduction: Breast Cutaneous Horn is a rare case whereby they are basically just nodules composed of keratin projecting above the surface the skin. Presentation of case: A 63-year-old lady, para 6 presented with a horn like growth for the past 2 years associated with itchiness. The horn increased in size to about a length of 5 cm associated with on and off itchiness over the horn. No signs and symptoms of malignancy. As comorbidities, patient has hypertension and dyslipidemia which is well controlled on medications. An ultrasound of the breast revealed cutaneous lesion at upper quadrant associated with adjacent skin thickening and no extension into breast parenchyma. A bedside excision was done and the specimen was sent for Histopathology. Histopathology of the lesion revealed Verruca Vulgaris. Discussion: This case brings to our attention a rare presentation of cutaneous horn over the breast along with its histological findings helping us to distinguish it with other similar cases. Best management would be by excision and to making sure to get a good specimen of the base for dermatopathological evaluation purpose. Conclusion: Cutaneous horns are usually benign lesions. However, there are chances of it being malignant. Therefore, it is best for early intervention such as excision followed by histopathological review for further thorough management.
