Occult primary breast cancer and cognates: Atypical today's cases inside a centenarian history

Abstract

Occult breast cancer (OBC) is a rare entity and, to date, still represents a diagnostic and therapeutic challenge. OBC is often diagnosed as metastatic dissemination without a recognized primary; this delay in diagnosis and the known increased tumor aggressiveness can condition treatment choices and patients’ outcomes. In this report, we describe three atypical presentations of breast cancer. The first corresponds to an OBC with axillary lymphadenopathy which is the most frequent finding in the literature. Another one describes diffuse bone metastases from breast tumors diagnosed through bone biopsy without any primitive breast lesion with all applied radiological imaging. The third one is instead an overt breast cancer with a pathological profile of a low aggressive tumor showing bulky lung involvement. The first OBC description dated back to Halstead's description in 1907 and represents a little-explored niche which however should be nowadays studied to define biological determinants probably influencing a different presentation and behavior

Keywords

• Occult breast cancer
• Cancer of unknown primary
• Bone metastases
• Lymphnode metastases