Carcinoma en cuirasse as a first sign of underlying breast carcinoma: a rare presentation

We report a case of a 65-year-old female who presented to the Dermatology Outpatient Clinic with large crusted indurated plaques and nodules on bilateral breast, which were sudden in onset, nonpruritic, slightly painful, and increasing in size over a period of 2 months. There was no history of any internal malignancy at the time of admission. A wedge biopsy was sent and the patient was admitted under surgery ICU with a provisional diagnosis of carcinoma en cuirasse. On the second day of admission, the patient died of respiratory failure and cardiac arrest. Hematoxylin and eosin-stained sections of biopsy were consistent with invasive ductal carcinoma breast. Carcinoma en cuirasse occurrence is normally seen during treatment of the primary breast tumor or after mastectomy. It may rarely precede the diagnosis of carcinoma of the breast. This is a rare and important case where carcinoma en cuirasse is the first manifestation of primary breast tumor.