{"id":"9fd54bf9-fdaa-494f-884c-aac02ab6cab1","slug":"malignancy-mimicking-infection-at-a-deep-brain-stimulation-chest-implant-site-diagnostic-pitfalls-and-management-challenges","title":"Malignancy mimicking infection at a deep brain stimulation chest implant site: Diagnostic pitfalls and management challenges","authors":["Tiago Oliveira","Miguel Ferreira","Teresa Pinheiro","João Lourenço","Joaquim Monteiro"],"abstract":"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.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/9fd54bf9-fdaa-494f-884c-aac02ab6cab1/featured/hero-1781557838362.png","publishDate":"2026-02-27T00:00:00.000Z","doi":"10.25259/SNI_719_2025","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/02/14351/SNI-17-112.pdf"}