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Kovács O, Kotsis L, Krasznai G. [Solitary oesophageal metastasis of breast cancer after 17 years latency]. Magy Seb 2007; 60:307-9. [PMID: 18065370 DOI: 10.1556/maseb.60.2007.6.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The authors discuss a case of a 63-year-old woman, who presented with dysphagia, 17 years after radical mastectomy for breast cancer. CT scan showed a juxta esophageal mediastinal tumour. A biopsy via right thoracotomy revealed a metastatic adenocarcinoma of the oesophageal wall from the previous breast carcinoma. Minimally invasive oesophageal intubation was used for palliation. Hormonal manipulation and radiotherapy was commenced postoperatively. The patient was well after eight months follow-up. A combination of high clinical suspicion with EUS and deep oesophageal biopsy can lead to the correct diagnosis of this very rare clinical entity. The biology of metastatic breast cancer may demand palliation by oesophageal intubation or stenting combined with adjuvant chemo, radio or hormonal therapy in such instances.
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Nazareno J, Taves D, Preiksaitis HG. Metastatic breast cancer to the gastrointestinal tract: A case series and review of the literature. World J Gastroenterol 2006; 12:6219-24. [PMID: 17036400 PMCID: PMC4088122 DOI: 10.3748/wjg.v12.i38.6219] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Metastatic breast cancer involving the hepatobiliary tract or ascites secondary to peritoneal carcinomatosis has been well described. Luminal gastrointestinal tract involvement is less common and recognition of the range of possible presentations is important for early and accurate diagnosis and treatment. We report 6 patients with a variety of presentations of metastatic breast cancer of the luminal gastrointestinal tract. These include oropharyngeal and esophageal involvement presenting as dysphagia with one case of pseudoachalasia, a linitis plastica-like picture with gastric narrowing and thickened folds, small bowel obstruction and multiple strictures mimicking Crohn’s disease, and a colonic neoplasm presenting with obstruction. Lobular carcinoma, representing only 10% of breast cancers is more likely to metastasize to the gastrointestinal tract. These patients presented with gastrointestinal manifestations after an average of 9.5 years and as long as 20 years from initial diagnosis of breast cancer. Given the increased survival of breast cancer patients with current therapeutic regimes, more unusual presentations of metastatic disease, including involvement of the gastrointestinal tract can be anticipated.
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Affiliation(s)
- Jose Nazareno
- Department of Medicine (Gastroenterology), University of Western Ontario, 529 McGarrell Place, London, Ontario, N6G5L3, Canada.
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3
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Kitamura H, Omachi T, Kobayashi C. Dislocation of the cervical oesophagus: a rare cause of oesophageal obstruction. Eur J Gastroenterol Hepatol 2005; 17:991-4. [PMID: 16093879 DOI: 10.1097/00042737-200509000-00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We describe a case of obstruction of the cervical oesophagus in which ultrasonography and computed tomography revealed characteristic dislocation of the cervical oesophagus and food impaction in a segmental canal. Although the patient presented with complete obstruction initially, spontaneous recovery of passage was achieved with conservative therapy. One recurrent episode was noted during her remaining life span. To our knowledge, no similar case has been described previously.
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Affiliation(s)
- Hiroshi Kitamura
- Department of Surgery, National Hospital Organization, Chushin Matsumoto National Hospital, Japan.
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4
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Sunada F, Yamamoto H, Kita H, Hanatsuka K, Ajibe H, Masuda M, Hirasawa T, Osawa H, Sato K, Hozumi Y, Sugano K. A case of esophageal stricture due to metastatic breast cancer diagnosed by endoscopic mucosal resection. Jpn J Clin Oncol 2005; 35:483-6. [PMID: 16006575 DOI: 10.1093/jjco/hyi123] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Metastasis of breast cancer to the esophagus has been reported but is rare. It is often difficult to diagnose metastases of breast cancer to the esophagus because they are often located in the submucosa and covered with normal mucosa. Although several methods have been reported in order to obtain specimens for pathological diagnosis, the adverse effects including bleeding and perforation were considerable problems. We report a case of a patient with esophageal stricture due to metastatic breast cancer to the esophagus. Pathological diagnosis was successfully obtained using endoscopic mucosal resection of the esophagus.
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Affiliation(s)
- Fumiko Sunada
- Department of Gastroenterology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Kawachi, Tochigi 329-0498, Japan
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Sobel JM, Lai R, Mallery S, Levy MJ, Wiersema MJ, Greenwald BD, Gunaratnam NT. The utility of EUS-guided FNA in the diagnosis of metastatic breast cancer to the esophagus and the mediastinum. Gastrointest Endosc 2005; 61:416-20. [PMID: 15758913 DOI: 10.1016/s0016-5107(04)02759-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Breast cancer can metastasize to the esophagus and the mediastinum. EUS-guided FNA (EUS-FNA) is being used increasingly as a less invasive alternative to mediastinoscopy for procuring a tissue diagnosis of mediastinal disease and may be useful for the diagnosis of breast cancer metastatic to the esophagus and the mediastinum. METHODS Twelve women (age range 54-82 years) with a history of breast cancer presented with dysphagia or other symptoms between 1 and 15 years after initial diagnosis and treatment. CT and endoscopy with biopsies suggested a mediastinal mass or lymphadenopathy with extrinsic esophageal compression but failed to provide a tissue diagnosis. EUS-FNA was performed for diagnosis. RESULTS Cytologic evaluation of specimens obtained by EUS-FNA confirmed breast cancer metastases in 11 of 12 patients (91%). Recurrent disease was found in intramural masses and periesophageal lymph nodes. No complication resulted from any EUS-FNA procedure. CONCLUSIONS EUS-FNA is safe and effective for the diagnosis of breast cancer metastases to the esophagus and the mediastinum. EUS-FNA may be useful as a first-line method of evaluation when breast cancer metastasis to the esophagus and the mediastinum is suspected.
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Affiliation(s)
- Jason M Sobel
- Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA
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LeBlanc J, Youssef W, DeWitt J, Sherman S, Chappo J, McHenry L. Metastatic breast cancer to the gastroesophageal junction 14 years after radical mastectomy. Gastrointest Endosc 2004; 59:733-6. [PMID: 15114327 DOI: 10.1016/s0016-5107(04)00293-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Julia LeBlanc
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA
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Fujii K, Nakanishi Y, Ochiai A, Tsuda H, Yamaguchi H, Tachimori Y, Kato H, Watanabe H, Shimoda T. Solitary esophageal metastasis of breast cancer with 15 years' latency: a case report and review of the literature. Pathol Int 1997; 47:614-7. [PMID: 9311012 DOI: 10.1111/j.1440-1827.1997.tb04550.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 68-year-old woman with a history of breast and colon cancer at the ages of 48 and 65 years, respectively, who presented with dysphagia is described. An upper gastrointestinal series and endoscopic examination revealed a circumferential stricture without ulceration in the middle-third area of the esophagus. Computed tomography demonstrated a submucosal tumor in the esophageal wall. A biopsy specimen obtained from the mucosa overlying the tumor revealed poorly differentiated adenocarcinoma, suggesting metastasis from the previous breast cancer. Subtotal esophagectomy with reconstruction was performed. Macroscopically, a submucosal tumor measuring 2.0 x 1.7 cm was observed in the resected esophagus. Microscopic examination revealed poorly differentiated adenocarcinoma, which was quite similar histologically to the breast cancer resected 15 years previously. Enzyme immunoassay and immunohistochemical analyses of the resected tumor revealed positivity for both estrogen and progesterone receptor, confirming the diagnosis of a metastatic cancer from the previous breast tumor.
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Affiliation(s)
- K Fujii
- Clinical Laboratory Division, National Cancer Center Hospital and Research Institute, Tokyo, Japan
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8
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Oka T, Ayabe H, Kawahara K, Tagawa Y, Hara S, Tsuji H, Kusano H, Nakano M, Tomita M. Esophagectomy for metastatic carcinoma of the esophagus from lung cancer. Cancer 1993; 71:2958-61. [PMID: 8490823 DOI: 10.1002/1097-0142(19930515)71:10<2958::aid-cncr2820711012>3.0.co;2-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A patient with metastatic carcinoma of the esophagus from lung cancer is reported. The patient was a 54-year-old woman who underwent a left lower lobectomy for lung cancer 5 years previously. The authors performed a thoracic esophagectomy, dissection of mediastinal lymph nodes, and reconstruction of the esophagus; the surgery was followed by chemotherapy. Because the histologic pattern of the esophageal tumor was similar to that of lung cancer and mucosal involvement was not seen, the esophageal tumor was interpreted to be a metastasis from lung cancer. The patient is well without recurrence of disease 23 months after operation. This is the first report of a successful esophagectomy for metastatic carcinoma of the esophagus from lung cancer.
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Affiliation(s)
- T Oka
- First Department of Surgery, Nagasaki University, School of Medicine, Japan
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9
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Wanamaker JR, Kraus DH, Eliachar I, Lavertu P. Manifestations of metastatic breast carcinoma to the head and neck. Head Neck 1993; 15:257-62. [PMID: 8491591 DOI: 10.1002/hed.2880150316] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Although metastatic neoplasms in the head and neck are rare compared to primary head and neck neoplasms, metastatic breast carcinoma has been described at numerous sites in the head and neck region. Two cases of breast carcinoma metastatic to sites in the head and neck are reported. In one case a laryngeal metastasis represented the first manifestation of recurrent breast cancer. The second case, a nasal metastasis, was unsuspected and was treated as cellulitis. The presentation of metastatic breast carcinoma to the head and neck may in fact be atypical, posing a diagnostic dilemma. These cases illustrate the importance of past medical history and the high index of suspicion in patients with a history of prior malignancy.
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Affiliation(s)
- J R Wanamaker
- Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Ohio 44195-5034
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10
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Foglia A, Descloux G, Galligioni E, Carbone A, Roma R, Fiaccavento G. Metastasi Esofagea Da Tumore a Cellule Chiare Del Rene. Urologia 1990. [DOI: 10.1177/039156039005700607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A. Foglia
- (U.L.S.S. n. 14 Portogruarese, Ospedale Civile di Portogruaro, Venezia, Servizio Autonomo di Urologia - Primario: dott. G. Fiaccavento, Divisione di Oncologia Medica C.R.O. di Aviano, Pordenone - Primario: dott. S. Monfardini, Istituto di Anatomia Patologica C.R.O. di Aviano, Pordenone - Primario: dott. A. Carbone, e Servizio di Radiologia dell'Ospedale Civile di Portogruaro, Venezia)
| | - G. Descloux
- (U.L.S.S. n. 14 Portogruarese, Ospedale Civile di Portogruaro, Venezia, Servizio Autonomo di Urologia - Primario: dott. G. Fiaccavento, Divisione di Oncologia Medica C.R.O. di Aviano, Pordenone - Primario: dott. S. Monfardini, Istituto di Anatomia Patologica C.R.O. di Aviano, Pordenone - Primario: dott. A. Carbone, e Servizio di Radiologia dell'Ospedale Civile di Portogruaro, Venezia)
| | | | | | | | - G. Fiaccavento
- (U.L.S.S. n. 14 Portogruarese, Ospedale Civile di Portogruaro, Venezia, Servizio Autonomo di Urologia - Primario: dott. G. Fiaccavento, Divisione di Oncologia Medica C.R.O. di Aviano, Pordenone - Primario: dott. S. Monfardini, Istituto di Anatomia Patologica C.R.O. di Aviano, Pordenone - Primario: dott. A. Carbone, e Servizio di Radiologia dell'Ospedale Civile di Portogruaro, Venezia)
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Shimada Y, Imamura M, Tobe T. Successful esophagectomy for metastatic carcinoma of the esophagus from breast cancer--a case report. THE JAPANESE JOURNAL OF SURGERY 1989; 19:82-5. [PMID: 2471861 DOI: 10.1007/bf02471573] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of progressive dysphagia due to metastatic carcinoma of the esophagus from breast cancer is described herein. The patient was a 55-year-old Japanese woman who had undergone a right radical mastectomy for carcinoma of the right breast 9 years previously. We performed a subtotal esophagectomy and reconstruction, using the stomach. She is now well and working without any further symptoms, five years after surgery. Thus, palliative surgery for the complications caused by metastatic carcinoma of the esophagus may be worthwhile.
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Affiliation(s)
- Y Shimada
- First Department of Surgery, Faculty of Medicine Kyoto University, Japan
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Abstract
A review of 62 cases of esophageal involvement by secondary neoplasms is reported. The common routes of esophageal involvement are by direct extension of the tumor from the contiguous or adjacent organs (45.2%), via mediastinal nodes (35.5%), and hematogenous spread from a distant primary (19.3%). In the first 2 modes of esophageal involvement, the diagnosis is usually obvious but hematogenous metastases to the esophagus usually pose a diagnostic challenge. Radiologically, hematogenous metastases show a spectrum of features consisting of a short segment of progressive stricture with normal to minimally irregular mucosa, a submucosal mass with or without ulceration, a polypoid mass or masses, and defects in esophageal motility including secondary achalasia. Since endoscopy and biopsy have limited diagnostic yield, radiologic diagnosis plays a key role in the diagnosis of secondary neoplasms of the esophagus irrespective of their mode of spread to the esophagus.
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