Relocation of the DBS IPG and antibiotic therapy failed to resolve erythema and edema due to recurrent breast carcinoma metastasis at the IPG site, leading to local progression and death within one year.
Case Report (n=1)
No
Malignancy should be considered in atypical implantable pulse generator site presentations, especially in patients with a prior cancer diagnosis, as it can mimic device-related infection.
Background: Deep brain stimulation (DBS) is a proven therapy for advanced Parkinson’s disease, but complications related to the implantable pulse generator (IPG) – such as infection, skin erosion, and device malfunction – can occur. Neoplastic involvement at the IPG site is exceedingly rare, with reports limited to cardiac pacemakers. Case Description: We describe a 77-year-old woman with bilateral subthalamic nucleus DBS (66 years old) who developed stage III invasive ductal carcinoma of the left breast (estrogen receptor-positive and human epidermal growth factor receptor 2 negative), 7 years later. After radical mastectomy and anti-estrogen therapy, she presented, 2 years later, with erythema and edema over the IPG pocket. Presumed infection was treated with antibiotics and generator relocation, without improvement. Imaging and subcutaneous biopsy subsequently confirmed cutaneous breast carcinoma recurrence confined to the IPG region, with no distant metastases. Despite palliative interventions, local progression led to her death 1 year later. Conclusion: This case underscores the need to consider malignancy in atypical IPG site presentations, especially in patients with prior cancer diagnosis.
Peçanha et al. (Fri,) conducted a case report in A 77-year-old woman with advanced Parkinson’s disease treated with bilateral subthalamic nucleus deep brain stimulation who developed recurrent invasive ductal carcinoma of the left breast involving the DBS implant site (n=1). Surgical debridement and relocation of the DBS implantable pulse generator (IPG) combined with systemic anti-estrogen therapy vs. Initial course of intravenous antibiotics was evaluated on Resolution of erythema and edema over DBS IPG pocket and disease progression at IPG site. Relocation of the DBS IPG and antibiotic therapy failed to resolve erythema and edema due to recurrent breast carcinoma metastasis at the IPG site, leading to local progression and death within one year.