• Yu-Fei Liu, Ling-Yu Liu, Shi-Lin Xia, Tao Li, and Jun Li.
• Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
• World Neurosurg. 2020 May 1; 137: 261-265.

BackgroundThe most common sites of breast cancer metastases are the bone, lung, liver, and brain. Scalp involvement in breast cancer metastasis is extraordinarily rare.Case DescriptionThis study reports a 52-year-old woman who had a history of malignant right breast cancer and underwent a mastectomy. Positron emission tomography/computed tomography revealed a soft tissue nodule measuring 1 × 0.7 cm located subcutaneously on the top left side of the scalp. A scalp mass excision operation was performed with an extended "S"-shaped incision, and the mass was sent for pathology. Immunohistochemistry showed the following results: CK7: +; ER: 2+, 90%; GATA3: +; GCDFP-15: scattered cells+; mammaglobin: -, napsin A: -; and TTF-1: -. These results were consistent with the characteristics of primary right breast cancer, supporting scalp metastasis from breast cancer.ConclusionsScalp metastasis from breast cancer is an exceedingly infrequent phenomenon. Close attention should be paid to soft tissue masses in patients with a healthy appearance and in those with a history of malignant cancer. When neurosurgeons operate on the mass, the circumscription and depth of the tumor must be given further attention.Copyright © 2020 Elsevier Inc. All rights reserved.

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