2 Massive Cardiac Metastases of an Untreated, Inflammatory Breast Cancer in a Young Patient: A Case Report of Autopsy Findings and Review of the Literature

Abstract

Inflammatory breast carcinoma is a rare, aggressive form of breast cancer with a rapid onset and a poor prognosis. Extensive lymphovascular invasion characterizes this disease process. Cardiac involvement is rare and usually is clinically unknown until autopsy examination. A case report of a 47-year-old Hispanic woman with inflammatory breast carcinoma and widely metastatic disease, including extensive cardiac involvement is presented. A literature review of this disease and the mechanism of retrograde pulmonary/mediastinum lymphatic microembolism is included. A literature review on the benefits of better access to medical care for underserved populations is also discussed. At the time of autopsy, metastases involving the lungs, liver, and mediastinal lymph nodes, as well as pleural and pericardial effusions were observed grossly. Microscopic examination confirmed massive cardiac metastases, including involvement of the myocardium. Additionally, unexpected involvement of multiple other organs was identified, including dermal lymphatic permeation of abdominal skin. Inflammatory breast cancer is an aggressive, rapidly progressive, and often fatal disease. Cardiac metastases are rare with inflammatory breast carcinoma, and the mechanism of cardiac dysfunction requires further study. This case illustrates the known devastating nature of this disease. It also provides the opportunities to study the cardiac dysfunction associated with myocardial metastases, and the need for improved access to medical care in underserved populations for early detection and treatment of disease.