Presentation
Palpable a mass in the right axilla.
Patient Data
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Conventional 4 view diagnostic mammogram.
Right off the bat you know you are dealing with multiple lesions in both breasts and in breast imaging this is most likely metastatic disease in the context of the age of the patient and the medical history. The lesions are multiple, dense, slightly spiculated and distributed throughout both breasts. There are lesions against the chest wall and in the axillae bilaterally.
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Bilateral breast ultrasound studies were performed. Multiple solid angular margin lesions of different sizes in both breasts and axillas. Large lesion on the left chest wall.
Case Discussion
This patient had been treated for a neuroendocrine tumor of the left lung 8 months previously. It was the oncologist who had found the axillary mass.
Ultrasound guided core biopsies confirmed metastatic large cell neuroendocrine carcinoma metastases.
From a sonology perspective the differential diagnosis should include melanoma.
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