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Research Article | Volume 19 Issue 2 (April-June, 2026) | Pages 146 - 150
Verrucous Cutaneous Metastasis Of Breast Carcinoma Arising On A Radiated Mastectomy Scar
1
Senior Resident, Department of Dermatology, Venereology and Leprosy, Medical College and Hospital, Kolkata, West Bengal, India
Under a Creative Commons license
Open Access
Received
May 5, 2026
Revised
May 15, 2026
Accepted
May 30, 2026
Published
June 5, 2026
Abstract

Cutaneous metastasis from breast carcinoma typically presents as papulonodular lesions or inflammatory patterns, while verrucous presentation is exceptionally rare and often mimics benign post-surgical changes. We report a middle-aged woman who presented with a five-year history of thickening and hyperpigmentation over the right mastectomy site following modified radical mastectomy, chemotherapy, rotational subtotal skin electron beam therapy, and Tamoxifen. The hyperpigmented, thickened skin progressively became verrucous and indurated, extending into the axillary fold as a painless, hyperkeratotic plaque with irregular surface, no ulceration, and no lymphadenopathy. Differential diagnoses included hypertrophic scar, lymphangioma circumscriptum, chronic lymphedema-associated changes, verrucous carcinoma, Marjolin ulcer, and cutaneous tuberculosis. Histopathological examination revealed epidermal hyperplasia with hyperkeratosis, dermal infiltration by atypical epithelial cells arranged in nests and cords, nuclear pleomorphism, dense desmoplastic stromal reaction, and focal duct-like structures consistent with cutaneous metastasis of breast carcinoma. This case highlights the diagnostic challenge of verrucous cutaneous metastasis mimicking benign scar tissue or primary verrucous carcinoma, with delayed presentation (five years post-mastectomy) contrasting typical early recurrences, underscoring that skin lesions at mastectomy sites warrant histopathological evaluation regardless of time elapsed. Early recognition and biopsy are crucial for appropriate management as cutaneous metastasis indicates disease recurrence and influences treatment strategy including systemic therapy and local control measures.

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