Alopecia neoplastica: An uncommon presentation of metastatic breast carcinoma

  • Felipe Ladeira de Oliveira Instituto IMS
  • Luisa Kelmer Cortês de Barros Silveira Department of Dermatology, Instituto Nacional de Câncer, Hospital do Câncer I, Rio de Janeiro, Brazil
  • Thais Schiavo Moraes Department of Dermatology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
  • Fernanda Helena Craide Department of Dermatology, Policlínica Geral do Rio de Janeiro, Rio de Janeiro, Brazil
  • Maria Cristina Mejia Briceño Department of Dermatology, Hospital Mario Kroeff, Rio de Janeiro, Brazil
  • Bernard Kawa Kac Diagnostika Lab, Rio de Janeiro, Brazil
Keywords: alopecia, breast cancer, metastasis, skin cancer


Cutaneous metastasis may correspond to the initial clinical presentation of hidden internal malignancies. In patients presenting said neoplasia, clinical manifestations of breast cancer reaches 23.9%. Considering that neoplastic alopecia appears as an unusual pattern of the said metastasis, this report describes a case of such uncommon neoplastic alopecia which presents itself as a cutaneous metastasis of rapid progression in a patient with prior breast cancer history. We present a 47-year-old female patient reporting lesions at the scalp, and who was asymptomatic with a 1-year evolution. The patient reported prior breast cancer history and presence of lung metastasis, and was undergoing chemotherapy at the time of consultation. A dermatological evaluation showed only a nodular lesion with erythematous surface and a diameter measuring about 4 cm, firm in consistency, and immovable. She was routed to the Department of Dermatological Surgery, and the results from histopathology were consistent with a diagnosis of metastatic breast adenocarcinoma. Neoplastic alopecia appears as an unusual form of cutaneous metastasis which is predominantly described in association with breast cancer. The lesion’s clinical features play a crucial role at the differential diagnosis, as the presence of erythema could distinguish neoplastic alopecia from alopecia areata. The existence of cutaneous metastasis leads to unfavorable outcomes. As a conclusion, cutaneous evaluation of patients is essential for treating visceral metastases, since the forms of cutaneous metastasis are diverse and can also affect the scalp.


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