Monday, April 21, 2008

Poor Prognosis

This is the breast of a 50 year old woman who presented with pain. It is tender, firm, and enlarged, but no masses are felt. The skin feels "thickened." There is no fever or leukocytosis.

Challenge: What's the unfortunate diagnosis here?

Image is shown under fair use.

4 comments:

mika said...

peau d'orange >> inflammatory breast cancer

I saw somewhere that the ddx includes cutaneous infection, sarcoidosis, or sclerederma - does that jive with what you found?

Alex said...

peu d' orange?

Craig said...

good job! i didn't read too much about the ddx (i probably should have) - but those make sense (though i still really don't know what sarcoidosis really is)

Craig said...

Poor Prognosis

The classic presentation of inflammatory breast cancer is a diffuse brawny induration of the skin with an erysipeloid edge usually without underlying palpable mass. This image is called a peau d’orange (skin of an orange) and generally represents inflammatory breast cancer. The skin color in this disease has a wide range. At presentation, almost all women have lymph node involvement and about 1/3 have distant metastases.

Sources: UpToDate; Loyola University Stritch School of Medicine website (meddean.luc.edu)