title: Metastatic breast disease from cutaneous malignant melanoma.
abstract: BACKGROUND
  Malignant melanoma is one of the most rapidly increasing cancer in the world. Breast metastases from melanoma are uncommon but could reflect a widespread disease.
  
  
  METHODS
  We report a case of malignant widespread melanoma presenting with bilateral breast nodules in a 39 year-old pre-menopausal Caucasian woman with an history of cutaneous melanoma of the trunk. Breast clinical examination revealed the presence of a hard and mobile lump located on the left breast. Ultrasound detected two bilateral nodules corresponding to oval opacities with well-defined edges and without calcifications or architectural distortion on mammography. Fine needle aspiration cytology performed on both breast nodules confirmed that the breast lesions were metastases from primary cutaneous malignant melanoma. A total-body CT examination detected brain, lung and abdominal lymph nodes metastases.
  
  
  CONCLUSIONS
  The breast represents an uncommon site of metastatic disease from extra-mammary tumors. Imaging features of breast metastases from melanoma usually do not allow a differential diagnosis with breast primary tumors. Breast metastases may be asymptomatic or palpable as dense and well-circumscribed nodules. Breast metastases indicate a widespread disease and should lead to avoid aggressive surgical procedures because of the poor prognosis of patients affected by metastatic melanoma.
  
  
  CONCLUSIONS
  The detection of bilateral breast metastases from melanoma is highly suggestive of metastatic multi-organ disease and could be useful to address the therapeutic approach.
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy. Electronic address: marco.moschetta@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschetta
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Telegrafo
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Nicola Maria
authors.initials: NM
authors.lastname: Lucarelli
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Martino
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Leonarda
authors.initials: L
authors.lastname: Rella
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Amato Antonio
authors.initials: AA
authors.lastname: Stabile Ianora
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Angelelli
keywords: Breast; Mammography; Melanoma; Metastasis; Ultrasound