title: Clitoral metastasis from ductal breast cancer revealing metastases in multiple sites and review of the literature.
abstract: BACKGROUND
  Clitoral metastasis from breast cancer is extremely rare.
  
  
  METHODS
  A 68-year-old woman with a 6-year previous history of breast cancer consulted her physician regarding a papillary and ulcerated clitoral lesion consistent with the appearance of vulvar squamous cell carcinoma. We analyzed the literature. Biopsy showed a ductal breast carcinoma with strongly positive estrogen and progesterone receptors. Magnetic resonance imaging of the pelvic area showed a second site on the right labium majus. Multiples metastases were detected. A right hemivulvectomy including the clitoris was performed, removing the 2 vulvar lesions. A nodule in the right breast and a cutaneaous lesion under the mastectomy scar were also removed. She refused chemotherapy, and initial hormonal therapy with anastrozole was switched to letrozol.
  
  
  CONCLUSIONS
  First, breast carcinoma on the vulva has 2 origins: primary breast carcinoma corresponding to ectopic breast tissue and--less frequently--breast cancer metastasis to the vulva. Second, the treatment of vulvar breast metastasis is the same as it would be on other sites: maximal reduction of the tumoral mass followed by chemotherapy-hormonal therapy.
authors: Department of Gynecology, Clinique du Val d'Ouest, Ecully, France. veronique.julien@laposte.net
authors: Véronique
authors: V
authors: Julien
authors: Michel
authors: M
authors: Labadie
authors: Guillaume
authors: G
authors: Gauthier
authors: Sandra
authors: S
authors: Ronger-Savle
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002987:Clitoris / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D014846:Vulvar Neoplasms / Q000556:secondary* / Q000601:surgery