Occult Breast Carcinoma Presenting as an Isolated Axillary Lymphadenopathy: A Case Report

The aim of this paper is to report a rare case of carcinoma breast and to explore current trends in the diagnosis, investigation and treatment of patients presenting with axillary lymph node metastases without a primary in the breast being found the so-called, 'occult' breast cancer. Occult primary breast cancer presenting as axillary metastasis is a rare entity of breast cancer. Diagnosis and treatment represent a real challenge in the absence of consensual attitude. We report here a case of occult breast cancer who presented with metastatic lymph nodes in the axilla. Although histology identified a metastatic adenocarcinoma in the lymph nodes, mammography failed to detect the primary tumor. Immunohistochemistry showed that the biopsied lymph nodes were positive for estrogen receptors, suggesting the breast as the site of the primary tumor. Breast MRI was normal. Axillary dissection was performed with breast conservation followed by, radiotherapy, adjuvant chemotherapy and hormonal therapy. She is under regular follow up without evidence of disease 18 months after surgery.