A 64-year old woman presented with extensive and painful lesions in both breasts that developed over the last 3 months. Physical examination revealed multiple fleshy, exophytic, malodorous and ulcerated masses involving the entire surface of both breasts. Erythematous and ulcerated plaques were also seen surrounding the lesions. [Figure 1]. Her past medical history was remarkable for in situ adenocarcinoma of her left breast treated with wide surgical excision and radiotherapy twenty years ago.

Figure 1

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Histopathological examination showed diffuse cutaneous infiltration of high-grade adenocarcinoma of the breast. Tumor cells were negative for hormonal and HER2/neu receptors. Computed tomography revealed involvement of thorax muscles with left pleural effusion and enlargement of the mediastinal lymph nodes [Figure 2]. Two liver nodules were also observed. With the diagnosis of stage IV breast adenocarcinoma, chemotherapy with paclitaxel was initiated with only partial improvement.

Figure 2

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Carcinoma en cuirasse was first described by Velpeau in 1838; this name was chosen because of its resemblance to the steel breastplate of a cuirassier. This form is a very uncommon clinicopathological presentation of cutaneous metastasis of breast carcinoma with poor prognosis that usually appears as a tumoral recurrence after a mastectomy.