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1
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Liu C, Xing H. Occult breast cancer in an older woman: A case report. Exp Ther Med 2025; 29:38. [PMID: 39781192 PMCID: PMC11707571 DOI: 10.3892/etm.2024.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/20/2023] [Indexed: 01/12/2025] Open
Abstract
Occult breast cancer (OBC) is a relatively rare clinical condition that can complicate differential diagnosis efforts and delay the administration of specific treatments. The individualized therapy of patients with OBC should be performed based on their clinical symptoms, imaging findings and pathological diagnosis. The present case study describes a 51-year-old woman with a painless left axillary tumor. The axillary lymph nodes of the patient were affected by invasive ductal carcinoma, as determined by histological analysis. However, the primary lesion was missed by numerous testing. The patient underwent surgery and testing for positron emission tomography/computed tomography (PET/CT). The present study comprehensively examined this case and offered a systematic analysis of the relevant scholarly works on the diagnosis, treatment and prognosis of OBC. Ultrasonography revealed the presence of three homogenous hypoechoic masses with irregular margins in the left axilla of the patient. PET/CT scanning identified multiple enlarged left axillary hypermetabolic lymph nodes. After that, the patient underwent a nipple-sparing mastectomy and an axillary lymphadenectomy. With the lymph nodes showing metastatic, infiltrating ductal carcinoma from the breast, ductal carcinoma in situ of the breast diagnosis was supported by a histological examination. Immunohistochemical staining revealed that resected lymph nodes were positive for both estrogen and progesterone receptors, consistent with the status of the breast as the primary tumor site. Following surgery, the patient underwent adjuvant chemotherapy treatment. At 12 months post-surgery, the patient remained well without evidence of disease. OBC cases lack the typical clinical and imaging findings associated with breast cancer, and a combination of axillary lymph node examination and immunohistochemistry is essential for accurately diagnosing affected patients. Ensuring the best patient outcomes necessitates accurate and prompt diagnosis, achieved by thorough physical examination, cautious utilization of diagnostic tools, personalized surgical interventions and histological investigation.
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Affiliation(s)
- Cong Liu
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Hua Xing
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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2
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Sasaki A, Masuda S, Yoshioka T, Saito A, Motomura Y. Therapeutic Effects of CDK4/6 Inhibitors in Gastric and Colonic Metastases From Breast Cancer: A Case Report. Cureus 2024; 16:e52765. [PMID: 38389643 PMCID: PMC10882214 DOI: 10.7759/cureus.52765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Breast cancer often metastasizes to the lungs, bones, liver, and brain; however, gastric and colonic metastases from breast cancer are rare. Nevertheless, here, we present the case of a 50-year-old woman diagnosed with recurrent breast cancer, exhibiting gastric and colonic metastases that were detected when she experienced intermittent abdominal pain. The differentiation between primary gastric cancer and metastasis from breast cancer was made through immunohistochemical staining. The patient underwent treatment with palbociclib, a cyclin-dependent kinase (CDK)4/6 inhibitor, and anastrozole, with no significant adverse effects. Subsequent upper and lower endoscopic examinations following the initiation of these treatments revealed tumor shrinkage in both gastric and colonic metastases. This case report presents the first instance in which morphological changes in gastrointestinal metastasis induced by CDK4/6 inhibitors could be evaluated.
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Affiliation(s)
- Akinori Sasaki
- Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN
| | - Shuko Masuda
- Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN
| | - Tsubasa Yoshioka
- Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN
| | - Akira Saito
- Pathology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN
| | - Yasuaki Motomura
- Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN
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3
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Yoshida T, Shimada A, Matsumoto K, Inukai M, Hashimoto R, Matsuda M, Nishi T, Seki H, Sakata M, Matsumoto H. A case study of pyloric stenosis caused by metastatic lobular carcinoma of breast. J Surg Case Rep 2023; 2023:rjad691. [PMID: 38163054 PMCID: PMC10755088 DOI: 10.1093/jscr/rjad691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Metastasis to the gastrointestinal tract is rare. A 59-year-old woman who had a history of an invasive lobular carcinoma of breast with clinical complete response visited our hospital and complained of an upper abdominal pain and distension. We performed an upper gastrointestinal endoscopy which showed only a gastric ulcer without any malignant findings. She experienced a recurrence of symptoms 2 months after this visit. An endoscopy revealed pyloric stenosis, which did not improve with balloon dilatation. We performed a gastro-jejunal and cecal-transverse colonic bypass surgery. Diffuse wall thickening of the antrum was verified during the surgery, and a biopsy sample was collected. The diagnosis of gastric metastasis from breast was confirmed since it showed the same immunohistochemistry pattern as the prior breast lesion. Pyloric stenosis has still been confirmed with an endoscopy, she has been alive with satisfactory oral food intake for >10 years.
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Affiliation(s)
- Taizo Yoshida
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Akihiko Shimada
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Koichi Matsumoto
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Michiko Inukai
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Ryo Hashimoto
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Mutsuhito Matsuda
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Tomohiko Nishi
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Hiroaki Seki
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Michio Sakata
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
| | - Hidetoshi Matsumoto
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8521, Japan
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Ibrahimli A, Aliyev A, Majidli A, Kahraman A, Galandarova A, Khalilzade E, Mammadli H, Huseynli K, Assaf K, Kilinc C, Muradov N, Alisan OF, Abdullayev S, Sahin YI, Samadov E. Metastasis to the stomach: a systematic review. F1000Res 2023; 12:1374. [PMID: 38706640 PMCID: PMC11066534 DOI: 10.12688/f1000research.140758.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 05/07/2024] Open
Abstract
Background: This study reviews the literature on gastric metastases (GM) in terms of diagnosis, treatment, and outcomes. The goal of this study was to provide clinicians with a reliable and beneficial source to understand gastric metastases arising from various primary tumors and to present the growing literature in an easily accessible form. Methods: Articles published in English language from implementation of MEDLINE and Cochrane databases until May 2022 were considered for the systematic review. Articles other than English language, letters to the editor, posters, and clinical images were excluded. Hematogenous and lymphogenic metastases were included whereas direct tumoral invasion and seeding were excluded. Articles and abstracts were analyzed and last selection was done after cross-referencing and by use of defined eligibility criteria. Results: In total 1,521 publications were identified and 170 articles were finally included totaling 186 patients with GM. The median age of patients was 62 years. Gynecologic cancer was the most common cancer type causing GM (67 patients), followed by lung cancer (33 patients), renal cancer (20 patients), and melanoma (19 patients). One of the main treatment methods performed for metastasis was resection surgery (n=62), sometimes combined with chemotherapy (ChT) or immunotherapy. ChT was the other most used treatment method (n=78). Also, immunotherapy was amongst the most preferred treatment options after surgery and ChT (n=10). Conclusions: As 172 case reports were screened in the systematic review from different journals, heterogeneity was inevitable. Some articles missed important information such as complete follow-up or clinical information. Moreover, since all of the included articles were case reports quality assessment could not be performed. Among 172 case reports reviewed, resection surgery was performed the most and was sometimes combined with ChT and immunotherapy. Further research about what type of treatment has the best outcomes for patients with gastric metastases is needed.
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5
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Bai X, Fang C, Liu B, Huagn J, Chen X, Xie X, Zhang Q, Liu M, Liang J, Guo J, Song L, Lan X, Chen L, Huang S, Deng W, Luo Z, Du C. Breast cancer metastases to the thyroid and stomach: A case report. Oncol Lett 2023; 26:386. [PMID: 37559588 PMCID: PMC10407839 DOI: 10.3892/ol.2023.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/07/2023] [Indexed: 08/11/2023] Open
Abstract
The most common sites of metastasis for breast cancer are the soft tissues, bones, lungs, liver and brain; however, metastases to the gastrointestinal tract and thyroid gland from breast cancer rarely occur. The present study describes the case of a 30-year-old woman who developed gastric and thyroid metastases 5 years after her initial diagnosis of invasive ductal breast carcinoma. The initial pathological diagnosis when receiving modified radical mastectomy was invasive ductal carcinoma, and further immunohistochemical examination revealed the cancer to be estrogen receptor (-), progesterone receptor (-), human epidermal growth factor receptor 2 (HER2; ++) and Ki-67 (70%). Genetic testing indicated the HER2 amplification mutation, whereas BRCA1/2 testing was negative. A total of 21 months after surgery, during regular follow-up, the patient was revealed to have developed an enlarged lymph node in the left side of the neck and the first recurrence was confirmed. Approximately 5 years after surgery, the patient gradually developed multi-site metastasis, and developed metastases to the thyroid gland and stomach confirmed by pathology and imaging. Combined chemotherapy and targeted therapy were administered and exhibited good efficacy; however, the patient subsequently died due to heart failure. This case report describes the occurrence of gastric and thyroid metastases from breast cancer, and highlights the importance of distinguishing between metastatic and primary tumors. Distinguishing between a metastatic and primary tumor is crucial as treatment protocols vary significantly for these two types of tumors. For patients with a history of breast cancer it should first be considered whether they have metastasis of the primary disease or discomfort caused by treatment; however, the possibility of a second primary tumor cannot be ignored. If the patient has symptoms such as loss of appetite, nausea, vomiting, stomach pain and stomach discomfort, a gastroscopy should be performed in a timely manner.
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Affiliation(s)
- Xue Bai
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Canbin Fang
- Cancer Center and Department of Breast and Thyroid Surgery, Xiang'an Hospital of Xiamen University, Xiamen, Fujian 361100, P.R. China
| | - Binliang Liu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P.R. China
| | - Jiayi Huagn
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Xuelian Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Xiaofeng Xie
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Qiuyi Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Meidi Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Jinyan Liang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Jinfeng Guo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Lin Song
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Xiaofeng Lan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Liping Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Suni Huang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Wencui Deng
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Zhenzhen Luo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Caiwen Du
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
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6
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Da Cunha T, Restrepo D, Abi-Saleh S, Dharan M. Breast cancer metastasizing to the upper gastrointestinal tract (the esophagus and the stomach): A comprehensive review of the literature. World J Gastrointest Oncol 2023; 15:1332-1341. [PMID: 37663940 PMCID: PMC10473935 DOI: 10.4251/wjgo.v15.i8.1332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/01/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
Breast cancer can infrequently metastasize to the upper gastrointestinal (GI) tract but the exact incidence is not well established-there is considerable variation between incidence reported from clinical studies and incidence noted in autopsy series. Clinical presentation can be very non-specific and often mimics primary gastrointestinal conditions. Endoscopy alone may not be sufficient to make a diagnosis and misdiagnosis is also common. A high degree of awareness and clinical suspicion is required to establish metastases to the upper GI tract. We undertook a comprehensive review of the available literature on breast cancer metastases to the esophagus and stomach including the clinical symptoms and presentation, endoscopic features, additional diagnostic imaging modalities, treatment and outcomes.
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Affiliation(s)
- Teresa Da Cunha
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - David Restrepo
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Simon Abi-Saleh
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Murali Dharan
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
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7
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Imai J, Hanamura T, Kawanishi A, Ueda T, Mishima Y, Ito A, Shirataki Y, Morimachi M, Kodama T, Sato H, Kaneko M, Sano M, Teramura E, Monma M, Tsuda S, Tsuruya K, Mizukami H, Arase Y, Fujisawa M, Miyahara S, Nakamura N, Suzuki T, Matsushima M, Suzuki H, Takashimizu S, Kagawa T, Nishizaki Y. A case of breast cancer with extensive colon metastasis. DEN OPEN 2023; 3:e189. [PMID: 36447634 PMCID: PMC9702338 DOI: 10.1002/deo2.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/29/2022]
Abstract
Breast cancer is one of the most common malignancies in women worldwide. Although most breast cancers are curable, in cases of metastasis, many are often found in the lungs, bones, liver, and central nervous system; however, metastasis to the gastrointestinal tract is rare. Invasive lobular carcinoma, which represents only 5%-10% of breast cancers, has a higher risk of metastasis to the gastrointestinal tract than invasive ductal carcinoma. Here, we report a rare case of gastrointestinal metastasis of invasive lobular carcinoma that spread extensively to the colonic mucosa. Given the improved survival rates of breast cancer patients with current treatments, many rarer metastatic diseases, including gastrointestinal metastases, are likely to be increased in the future.
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Affiliation(s)
- Jin Imai
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
| | - Toru Hanamura
- Department of Breast and Endocrine SurgeryTokau University School of MedicineIseharaKanagawaJapan
| | - Aya Kawanishi
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Takashi Ueda
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yusuke Mishima
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Ayano Ito
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yoshihiro Shirataki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masashi Morimachi
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Toshio Kodama
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hirohiko Sato
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Motoki Kaneko
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masaya Sano
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Erika Teramura
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Makiko Monma
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Shingo Tsuda
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Kota Tsuruya
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hajime Mizukami
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yoshitaka Arase
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Mia Fujisawa
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Saya Miyahara
- Department of PathologyTokai University School of MedicineIseharaKanagawaJapan
| | - Naoya Nakamura
- Department of PathologyTokai University School of MedicineIseharaKanagawaJapan
| | - Takayoshi Suzuki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masashi Matsushima
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hidekazu Suzuki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Shinji Takashimizu
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
| | - Tatehiro Kagawa
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yasuhiro Nishizaki
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
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8
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Fousekis FS, Tepelenis K, Stefanou SK, Stefanou CK, Pappas-Gogos G, Theopistos V, Evangelou Z, Mauri D, Christodoulou DK. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac080. [PMID: 35308257 PMCID: PMC8929746 DOI: 10.1093/jscr/rjac080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Gastric metastasis from breast cancer occurs infrequently and causes non-specific symptoms, usually attributed to the underlying disease. Furthermore, endoscopic findings are almost identical to primary gastric cancer, making the immunohistochemical examination of biopsies necessary for diagnosis. We present the case of a 64-year-old woman who was diagnosed with lobular breast cancer 3 years ago and received chemotherapy with evidence of remission. The patient presented with dyspepsia and progressive dysphagia for the last 6 months, not responsive to PPI treatment. Upper endoscopy revealed partial occlusion of the cardio-esophageal junction and thickened gastric folds resembling linitis plastica. However, immunohistochemical analysis of endoscopic biopsies showed infiltration of gastric mucosa by lobular breast cancer cells, making the diagnosis of gastric metastasis. Therefore, clinicians’ awareness of possible gastric metastasis is warranted in patients with a history of advanced breast cancer and severe gastric symptoms.
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Affiliation(s)
- Fotios S Fousekis
- Department of Gastroenterology and Hepatology, University Hospital of Ioannina, Ioannina, Greece
| | - Kostas Tepelenis
- Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Stefanos K Stefanou
- Department of Surgery, General Hospital of Ioannina “G. Xatzikosta”, Ioannina, Greece
| | - Christos K Stefanou
- Correspondence address. Cyprus 3, Ioannina 45500, Greece. Tel: +306942071910; Fax: +302651077630; E-mail:
| | | | - Vasileios Theopistos
- Department of Gastroenterology and Hepatology, University Hospital of Ioannina, Ioannina, Greece
| | - Zoi Evangelou
- Department of Pathology, University Hospital of Ioannina, Ioannina, Greece
| | - Davide Mauri
- Department of Oncology, University Hospital of Ioannina, Ioannina, Greece
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9
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A Rare Metastatic Site of Invasive Lobular Breast Carcinoma: A Case Report. Case Rep Surg 2021; 2021:9922296. [PMID: 34853710 PMCID: PMC8629669 DOI: 10.1155/2021/9922296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022] Open
Abstract
Here, we report a case of a 42-year-old female patient with left lobular breast cancer-gastric metastasis (initially misdiagnosed five years ago as an invasive ductal carcinoma) presenting with dyspepsia, weight loss, and persistent vomiting lasting for four weeks. Upper GI endoscopy revealed evidence of linitis plastica, and histological and immunocytochemical analyses of the biopsy confirmed gastric metastasis secondary to invasive lobular breast carcinoma.
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10
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Maharajh S, Capildeo K, Barrow M, Islam S, Naraynsingh V. Case report of metastatic breast cancer mimicking ileal Crohn's disease. Int J Surg Case Rep 2021; 87:106408. [PMID: 34534815 PMCID: PMC8449070 DOI: 10.1016/j.ijscr.2021.106408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/28/2021] [Accepted: 09/11/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Lobular breast cancer (LBC) has an increased risk of gastrointestinal (GI) spread compared with ductal breast carcinoma. Breast cancer commonly metastasises to bone, lung, liver, central nervous system and rarely to the gastrointestinal tract. As the prognosis for breast cancer continues to improve with modern medical practice it is important to be aware of the various clinical presentations and the appropriate management of breast cancer metastases. Case presentation We describe a case of a 60-year-old woman who presented with symptoms of bowel obstruction 30 months after undergoing mastectomy and adjuvant chemotherapy for LBC. A Computer Tomography (CT) scan showed terminal ileal thickening suggestive of Crohn's disease but histopathology revealed metastatic lobular carcinoma. Surgical resection to relieve her small bowel obstruction confirmed LBC. Clinical discussion This case illustrates an unusual presentation of metastatic breast cancer causing small bowel obstruction with radiological features mimicking Crohn's disease. Conclusion Patients with breast cancer can present with intestinal obstruction due to metastatic spread to the small intestine; this may resemble Crohn's disease clinically and radiologically.
Lobular breast cancer is more likely to metastasize to the gastrointestinal tract. Breast cancer metastases can appear radiologically as Crohn’s disease. Endoscopic biopsies in cases of GI spread of breast cancer can be nondiagnostic.
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Affiliation(s)
| | - Kavi Capildeo
- Department of Clinical Medicine, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Mickhaiel Barrow
- Department of Cellular Pathology, Port of Spain General Hospital, Trinidad and Tobago
| | - Shariful Islam
- Department of Clinical Surgical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Vijay Naraynsingh
- Department of Clinical Surgical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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11
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Shih-Chun C, Shih-Chiang H, Chun-Yi T, Shan-Yu W, Keng-Hao L, Jun-Te H, Ta-Sen Y, Chun-Nan Y. Non-small cell lung cancer with gastric metastasis and repeated gastrointestinal bleeding: A rare case report and literature review. Thorac Cancer 2021; 12:560-563. [PMID: 33403816 PMCID: PMC7882379 DOI: 10.1111/1759-7714.13815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 12/28/2022] Open
Abstract
The occurrence of gastrointestinal metastasis from lung carcinoma is rare. Compared with non-small cell lung cancer (NSCLC), small cell lung cancer more commonly results in this sort of metastasis. Here, we report an unusual case of NSCLC initially without evidence of distant metastasis that developed into gastric metastasis five months after the initial diagnosis, despite the primary lung cancer having a partial response to radiotherapy and chemotherapy. Serial radiological examinations and endoscopic biopsies of the gastric tumor confirmed that it was a metastatic carcinoma originating from the lung. The patient received a total gastrectomy for gastric metastasis due to repeated gastrointestinal bleeding.
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Affiliation(s)
- Chang Shih-Chun
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Huang Shih-Chiang
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Tsai Chun-Yi
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Wang Shan-Yu
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Liu Keng-Hao
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Hsu Jun-Te
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Yeh Ta-Sen
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Yeh Chun-Nan
- Departments of General Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
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12
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Geada L, Kantor M, Mohan K, Weingrad D, Nasiff LS. An Uncommon Presentation of a Common Disease: A Review of Gastric Metastasis From Breast Carcinoma. Cureus 2020; 12:e11920. [PMID: 33425505 PMCID: PMC7785476 DOI: 10.7759/cureus.11920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is the most common cancer in women, and the leading cause of cancer-related deaths worldwide. Despite advances in screening and treatment modalities, distant metastasis still develops. Breast cancer metastasis to the gastrointestinal tract is very rare, therefore, its diagnosis, therapeutic strategies, and prognosis pose a clinical problem for clinicians. We summarize the current knowledge regarding the clinicopathological characteristics and diagnostic strategies for metastatic tumors in the stomach of breast origin.
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Affiliation(s)
- Luis Geada
- Department of General Surgery, Aventura Hospital and Medical Center, Miami, USA.,Department of General Surgery, Kendall Regional Medical Center, Miami, USA
| | - Micaella Kantor
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
| | - Karthik Mohan
- Department of Gastroenterology, Palmetto General Hospital, Miami, USA
| | - Daniel Weingrad
- Department of Surgical Oncology, Aventura Hospital and Medical Center, Miami, USA
| | - Luis S Nasiff
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
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13
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Clinical Characteristics and Prognosis of Gastrointestinal Metastases in Solid Tumor Patients: A Retrospective Study and Review of Literatures. Anal Cell Pathol (Amst) 2019; 2019:4508756. [PMID: 31929965 PMCID: PMC6939450 DOI: 10.1155/2019/4508756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/18/2019] [Indexed: 01/11/2023] Open
Abstract
Background According to the literature and our experience, patients with gastrointestinal metastases are relatively rare. Numerous case reports and literature reviews have been reported. We present one of the larger case series of gastrointestinal metastases. Objectives To explore the clinical characteristics and prognosis of patients with gastrointestinal tract metastases, which are rare metastatic sites. Methods Patients with gastrointestinal metastases in the setting of stage IV primary carcinomas treated at Beijing Ditan Hospital and Peking University International Hospital from November 1992 to August 2017 were included in this study. The diagnosis of gastrointestinal tract metastases was based on histopathology. Results 30 patients (median age 56 years, 56.7% female) were included. The most common primary carcinomas associated with gastrointestinal metastases were breast (11 patients, 36.7%), stomach (9 patients, 30.0%), and lung (4 patients, 13.3%) cancer. The major pathological types were adenocarcinoma (16 patients, 53.3%) and ductal carcinoma (9 patients, 30.0%). Ten patients (33.3%) underwent local gastrointestinal treatment, and 20 patients (66.7%) underwent nonlocal treatment (involving chemotherapy alone or best supportive care). For breast cancer patients and gastric cancer patients who underwent local therapy, a significant survival advantage was observed (p = 0.001 and p = 0.012, respectively). The presence of other common metastases was identified as an independent poor prognostic factor through multivariate analysis with a HR (hazard ratio) of survival of 0.182 (95% confidence interval (CI) 0.11-0.523, p = 0.031). Conclusion Gastrointestinal metastases are most frequently from breast invasive ductal carcinoma. The presentation of other common metastases with gastrointestinal metastasis indicates poor prognosis, and selected patients may benefit from surgical intervention.
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14
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Specific Histopathologic Features Aid in Distinguishing Diffuse-type Gastric Adenocarcinoma From Metastatic Lobular Breast Carcinoma. Am J Surg Pathol 2019; 44:77-86. [DOI: 10.1097/pas.0000000000001341] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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15
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Bushan K, Kammar P, Singh C, Advani S, Mahajan P. Infiltrating Lobular Breast Cancer Presenting as Isolated Gastric Metastasis: a Case Report. Indian J Surg Oncol 2018; 9:318-322. [PMID: 30287990 DOI: 10.1007/s13193-017-0705-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/12/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Kirti Bushan
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Praveen Kammar
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Chandraveer Singh
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Suresh Advani
- Department of Medical Oncology, Asian Cancer Institute, Mumbai, India
| | - Praveen Mahajan
- Department of Pathology, Asian Cancer Institute, Mumbai, India
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16
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Khan I, Malik R, Khan A, Assad S, Zahid M, Sohail MS, Yasin F, Qavi AH. Breast Cancer Metastases to the Gastrointestinal Tract Presenting with Anemia and Intra-abdominal Bleed. Cureus 2017; 9:e1429. [PMID: 28924517 PMCID: PMC5587403 DOI: 10.7759/cureus.1429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 07/06/2017] [Indexed: 11/05/2022] Open
Abstract
Signet ring adenocarcinoma of the breast with synchronous metastasis to the gastrointestinal (GI) tract is a rare occurrence, typically presenting with abdominal pain, dyspepsia, or GI bleed. We report a case of metastatic breast cancer presenting with a complaint of anemia. A further diagnostic evaluation revealed generalized lymphadenopathy, nodular thickening of the urinary bladder wall, bone lesions, and enlarged pancreas. Biopsies from the lymph nodes, pancreatic biopsy, and bladder nodule all revealed a signet cell carcinoma. An upper and lower GI endoscopy revealed multiple ulcerated gastric mucosal nodules and polypoid folds in the cecum and proximal ascending colon; the biopsies from these lesions were also positive for signet ring cell adenocarcinoma.
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Affiliation(s)
- Idrees Khan
- Center for Healthcare Advancement & Outcomes Research, Baptist Health Medical Group
| | - Rehan Malik
- Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida
| | - Amina Khan
- Shifa Tameer E Millat University, Shifa International Hospital, Islamabad, Pakistan
| | - Salman Assad
- Department of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Mehr Zahid
- Internal Medicine, University of Lahore, Lahore, Pakistan
| | | | - Faizan Yasin
- Department of Medicine, Shifa Tameer-e-Millat University
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17
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Agnes A, Estrella JS, Badgwell B. The significance of a nineteenth century definition in the era of genomics: linitis plastica. World J Surg Oncol 2017; 15:123. [PMID: 28679451 PMCID: PMC5498981 DOI: 10.1186/s12957-017-1187-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 06/22/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Linitis plastica due to gastric adenocarcinoma is a condition with a long history, but still lacks a standardized definition and is commonly confused with Borrmann type IV, Lauren diffuse, and signet-cell type gastric cancer. The absence of a clear definition is a problem when investigating its biological characteristics and role as a possible independent factor for prognosis. Nevertheless, the biological behavior for linitis plastica, which is unique, may be valuable in risk stratification and have implications for treatment. A definition of linitis plastica based on molecular or genomic criteria could represent a useful starting point for investigating new targeted therapies. MAIN BODY This literature review of linitis plastica will focus on the current classifications for gastric cancer, illustrating how the concept of linitis plastica relates to them in most cases and identifying a clear and reproducible definition. Moreover, the review will highlight the diagnostic challenges associated with linitis plastica, its prognostic implications, and the therapeutic options available. Future perspectives for its management are also addressed. CONCLUSION Linitis plastica is a carcinoma with a scirrhous stroma, involving the submucosal and muscular layers of the stomach even in the absence of mucosal alteration. In most cases, the primary cancer cells are signet-ring cells or scattered cells in the context of a poorly differentiated carcinoma. Diagnosis is challenging. Staging should be thorough, including diagnostic laparoscopy in all cases due to the high incidence of peritoneal involvement. The prognostic significance of linitis plastica is still controversial. Curative-intent surgery, when feasible, should be performed, with a multimodality treatment approach. Cancer-stroma interactions are important features of this disease, and represent attaining potential target for future therapies. Future pathologic assessments of gastric cancer should report the stromal reaction in order to allow better characterization of the tumor.
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Affiliation(s)
- Annamaria Agnes
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Unit 1484, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Jeannelyn S Estrella
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brian Badgwell
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Unit 1484, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
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18
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de Zárraga Mata C, Thomas Salom G, Vilella Martorell A, Salvà Ramonell F, Maura Oliver ÁL, Dolz Abadía C. Gastric metastatic extension of invasive ductal carcinoma of the breast with atypical endoscopic presentation. GASTROENTEROLOGIA Y HEPATOLOGIA 2017. [PMID: 28625415 DOI: 10.1016/j.gastrohep.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Guiem Thomas Salom
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, España
| | | | | | | | - Carlos Dolz Abadía
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, España
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19
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Rodrigues MVR, Tercioti-Junior V, Lopes LR, Coelho-Neto JDS, Andreollo NA. BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ? ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2017; 29:86-9. [PMID: 27438032 PMCID: PMC4944741 DOI: 10.1590/0102-6720201600020005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
Abstract
Background: Breast cancer is the most common malignant neoplasm in the female population.
However, stomach is a rare site for metastasis, and can show up many years after
initial diagnosis and treatment of the primary tumor. Aim: Analyze a case series of this tumor and propose measures that can diagnose it with
more precocity. Methods: Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has
demonstrated that primary tumor was breast cancer. We retrieved information of
age, histological type, interval between diagnosis of the primary breast cancer
and its metastases, immunohistochemistry results, treatment and survival. Results: The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent
mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had
diagnosis of both primary and secondary tumors concomitantly. At average,
diagnosis of gastric metastasis was seven years after diagnosis of primary breast
cancer (ranging 0-13). Besides, nine cases had also metastases in other organs,
being bones the most affected ones. Immunohistochemistry of the metastases has
shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%,
progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12
cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2
marker did not present statistical significance (41.67%). Eight cases were treated
with chemotherapy associated or not with hormonal blockade. Surgical treatment of
gastric metastasis was performed in four cases: three of them with total
gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival
of 14.58 months after diagnosis of metastasis, with only two patients still alive.
Conclusion: Patients with a history of breast cancer presenting endoscopic diagnosis of
gastric cancer it is necessary to consider the possibility of gastric metastasis
of breast cancer. The confirmation is by immunohistochemistry and gastrectomy
should be oriented in the absence of other secondary involvement and control of
the primary lesion.
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Affiliation(s)
- Marcus Vinicius Rozo Rodrigues
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Valdir Tercioti-Junior
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Luiz Roberto Lopes
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - João de Souza Coelho-Neto
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Nelson Adami Andreollo
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
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20
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Villa Guzmán JC, Espinosa J, Cervera R, Delgado M, Patón R, Cordero García JM. Gastric and colon metastasis from breast cancer: case report, review of the literature, and possible underlying mechanisms. BREAST CANCER-TARGETS AND THERAPY 2016; 9:1-7. [PMID: 28096693 PMCID: PMC5207330 DOI: 10.2147/bctt.s79506] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Gastrointestinal metastases from breast cancer are not common. We present a 58-year-old female diagnosed with lobular breast cancer some years before whose relapses were gastric and colonic mucosal. Simultaneous metastases are extremely rare. To our knowledge, no cases of initial dual affectation have been reported. The patient also showed gastritis by Helicobacter pylori. Invasive lobular breast carcinoma is the most frequent special type of breast cancer and carries some specific molecular alterations such as loss of expression of E-cadherin. Although underlying mechanisms of metastasization are not entirely known, chemokines as well as inflammatory events seem to be implicated in this process. Interaction between chemokines and their receptors frequently induces cell migration. We hypothesize that H. pylori, inflammatory cells, and chemokines may create a favorable environment attracting tumor cells.
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Affiliation(s)
| | | | | | | | - R Patón
- Department of Gastroenterology
| | - J M Cordero García
- Department of Nuclear Medicine, University Ciudad Real General Hospital, Ciudad Real, Spain
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21
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Dos Santos Fernandes G, Batista Bugiato Faria LD, de Assis Pereira I, Neves NCM, Vieira YO, Leal AIC. Gastric Metastasis of Breast Cancer: A Case Series. Rare Tumors 2016; 8:6305. [PMID: 27746881 PMCID: PMC5064297 DOI: 10.4081/rt.2016.6305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/29/2016] [Accepted: 01/30/2016] [Indexed: 01/10/2023] Open
Abstract
Gastric metastasis is rare but it can be the initial symptom of cancer. The second leading cause of this type of metastasis is breast cancer. A lack of clinical signs and nonspecific side effects of the treatment of primary tumors can lead to the misdiagnosis of metastatic gastric cancer. Upper gastrointestinal endoscopy with biopsy and immunohistochemistry should be used for diagnosis. Treatment is palliative; it includes chemo, endocrine, and radiation therapies. Four patients with breast cancer and gastric metastasis were identified. All the patients tested positive for estrogen and progesterone receptors, and received chemotherapy and hormone therapy. One patient underwent surgery and two received radiation therapy. Patients with breast cancer and gastrointestinal symptoms should be investigated for gastric metastasis, given its morbidity and negative impact on quality of life.
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22
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Ricciuti B, Leonardi GC, Ravaioli N, De Giglio A, Brambilla M, Prosperi E, Ribacchi F, Meacci M, Crinò L, Maiettini D, Chiari R, Metro G. Ductal Breast Carcinoma Metastatic to the Stomach Resembling Primary Linitis Plastica in a Male Patient. J Breast Cancer 2016; 19:324-329. [PMID: 27721883 PMCID: PMC5053318 DOI: 10.4048/jbc.2016.19.3.324] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/25/2016] [Indexed: 02/07/2023] Open
Abstract
Breast cancer metastases to the gastrointestinal tract are very rare occurrences. Among the histological subtypes of breast cancer, invasive lobular carcinomas have a high capacity of metastasis to uncommon sites including the stomach. Conversely, there has not been sufficient evidence supporting the gastric metastasis of invasive ductal carcinoma. Herein, we report a unique case of metastatic ductal breast carcinoma mimicking primary linitis plastica in a male patient, particularly focusing on the clinical and pathological features of presentation. Moreover, we propose a immunohistochemical panel of selected antibodies including those for cytokeratin 20, cytokeratin 7, estrogen receptor, progesterone receptor, E-cadherin, gross cystic disease fluid protein 15, and GATA binding protein 3 for an accurate differential diagnosis.
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Affiliation(s)
- Biagio Ricciuti
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Noemi Ravaioli
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Andrea De Giglio
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Marta Brambilla
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Enrico Prosperi
- Department of Experimental Medicine and Biochemical Sciences, Section of Anatomic Pathology and Histology, University of Perugia, Perugia, Italy
| | - Franca Ribacchi
- Department of Diagnostic Cytology and Histology Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Marialuisa Meacci
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Lucio Crinò
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Daniele Maiettini
- Department of Diagnostic Imaging, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Rita Chiari
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giulio Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
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23
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El-Hage A, Ruel C, Afif W, Wissanji H, Hogue JC, Desbiens C, Leblanc G, Poirier É. Metastatic pattern of invasive lobular carcinoma of the breast-Emphasis on gastric metastases. J Surg Oncol 2016; 114:543-547. [PMID: 27406466 DOI: 10.1002/jso.24362] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/28/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Breast invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) have different metastatic patterns, but the exact pattern of metastases from ILC is poorly known. This study aimed to determine the frequency of ILC metastases in atypical locations, with an emphasis on gastric metastases. METHODS Patients with ILC treated at the Saint-Sacrement Hospital (Quebec City, Canada) and the Maisonneuve-Rosemont Hospital (Montreal, Canada) between January 2003 and December 2009 were retrospectively reviewed. Demographic, clinical, and follow-up data were retrieved from the medical charts. Metastases that were diagnosed during follow-up were recorded. RESULTS Among the 481 patients with ILC, 74 (15.4%) were diagnosed with metastases after a median follow-up of 46 months. Among these 74 patients, 41.9% had metastases in atypical sites. Five patients were diagnosed with histologically confirmed gastric metastases of ILC. CONCLUSION Metastases of breast ILC to atypical sites might be more frequent than previously reported. Clinicians should keep a high level of suspicion when a patient with a history of ILC develops digestive symptoms. It is important to differentiate metastases from a primary GI tumor by using immunohistochemical markers. J. Surg. Oncol. 2016;114:543-547. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ali El-Hage
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Carolanne Ruel
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Wahiba Afif
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada
| | - Hussein Wissanji
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Jean-Charles Hogue
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada.,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada.,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Christine Desbiens
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada.,Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada.,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada.,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Guy Leblanc
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada
| | - Éric Poirier
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada. .,Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada. .,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada. .,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.
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24
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Kim YS, Jae EA, Ryu DW, Lee CH. Peritoneal and gastric metastasis from invasive lobular breast carcinoma: a case report. KOSIN MEDICAL JOURNAL 2015. [DOI: 10.7180/kmj.2015.30.1.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Peritoneal and gastrointestinal metastasis from breast cancer is very rare. We report here a rare case of metastatic peritoneal and gastric cancer from breast lobular carcinoma after modified radical mastectomy. A 65-year old woman presented with anorexia, nausea, vomiting and dyspepsia for several weeks at 44 months after surgery. Radiologic study showed peritoneal metastasis, and surgical histopathology reported peritoneal and omental metastatic carcinoma. Esophagogastroduodenoscopic (EGD) biopsy also confirmed metastatic carcinoma originated from breast primary.
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25
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Synchronous Orbital and Gastrointestinal Metastases from Breast Cancer: A Case Report and Review of Literature. Case Rep Oncol Med 2015; 2015:282790. [PMID: 26075123 PMCID: PMC4444565 DOI: 10.1155/2015/282790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/04/2015] [Indexed: 12/22/2022] Open
Abstract
Breast cancer is the most common malignancy among women and is a significant cause of morbidity and mortality worldwide. With the advent of improved imaging techniques and screening programmes, only a small proportion of women present with metastatic disease. Metastases involving the gastrointestinal (GI) tract and orbit are rare occurrences. We describe the case of a woman with simultaneous GI and orbital metastases from breast cancer who initially presented with abdominal pain and blurred vision and also summarise a review of the literature.
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26
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Osaku T, Ogata H, Magoshi S, Kubota Y, Saito F, Kanazawa S, Kaneko H. Metastatic nonpalpable invasive lobular breast carcinoma presenting as rectal stenosis: a case report. J Med Case Rep 2015; 9:88. [PMID: 25902937 PMCID: PMC4414004 DOI: 10.1186/s13256-015-0568-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/05/2015] [Indexed: 12/14/2022] Open
Abstract
Introduction Invasive lobular carcinomas have an increased propensity for distant metastases, particularly to the peritoneum, ovaries, and uterus. In contrast, distant metastases of nonpalpable lobular carcinomas are extremely rare, and the causes of underlying symptoms of primary carcinomas remain unclear. We report a case of an asymptomatic invasive lobular carcinoma with a primary mammary lesion in a patient with rectal stenosis. Case presentation A 69-year-old Japanese woman presented to our hospital for treatment of constipation. Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause. Thus, an exploratory laparotomy and tissue biopsy was performed, and the presence of an invasive lobular carcinoma was confirmed. Subsequent breast examinations showed that the invasive lobular carcinoma that led to the rectal stenosis was a metastatic lesion from a primary lesion of the breast duct. As the present breast lobular carcinoma was asymptomatic and nonpalpable, we did not initially consider metastatic breast cancer as a cause of her symptoms, and the final diagnosis was delayed. Conclusions Peritoneal metastasis from nonpalpable invasive lobular carcinomas is very rare. However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.
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Affiliation(s)
- Tadatoshi Osaku
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Hideaki Ogata
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Shunsuke Magoshi
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Yorichika Kubota
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Fumi Saito
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Shinsaku Kanazawa
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
| | - Hironori Kaneko
- Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan.
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Unexpected diagnosis of both adenocarcinoma of the colon and metastatic lobular carcinoma of the breast in the gastrointestinal tract. Case Rep Pathol 2013; 2013:153180. [PMID: 23984147 PMCID: PMC3741921 DOI: 10.1155/2013/153180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/30/2013] [Indexed: 12/26/2022] Open
Abstract
Breast cancer rarely metastasises to the gastrointestinal tract. Lobular carcinoma more commonly metastasises to the uterus and appendages, peritoneum, and gastrointestinal tract than other types of breast cancer, while ductal carcinoma has a propensity to metastasise to the lungs, liver, and brain. We describe the case of a patient with no known history of breast cancer, whose primary presentation of lobular breast cancer was with malignant small intestinal and colonic strictures, with coexisting previously undiagnosed adenocarcinoma of the colon.
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Razzetta F, Tassara E, Saro F, Sironi M, D'Ambrosio G. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg 2011; 63:129-33. [PMID: 21286894 DOI: 10.1007/s13304-011-0047-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/14/2011] [Indexed: 02/08/2023]
Abstract
Intra-abdominal metastases from breast carcinomas are rarely reported in the literature. Least are those originating from occult breast primary. We report, one case of pancreatic metastasis and one case of metastatic infiltration of the colonic wall, both by occult lobular breast carcinoma. The first patient underwent pancreaticoduodenectomy for obstructive jaundice, with unexpected histological finding of infiltration of distal bile duct, pancreatic gland, portal vein and retroperitoneal soft tissue by lobular carcinoma of the breast. The second patient complained of diffuse abdominal pain associated with constipation and rectal bleeding and underwent endoscopic biopsy of three intestinal strictures, revealing metastatic lobular carcinoma with signet-ring cell morphology. In both cases, a subsequent complete diagnostic work-up demonstrated asymptomatic multiple breast nodules, diagnosed as lobular carcinoma by fine needle aspiration cytology.
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Affiliation(s)
- Francesco Razzetta
- Anatomia Patologica, Ospedale di Sestri Levante, Via Terzi 43/a, 16039 Sestri Levante (Genoa), Italy
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Szabó J, Falkus B, Simon E, Brünner S, Baranyay F. [Late gastrointestinal metastases of invasive lobular breast carcinoma mimicking Crohn's disease]. Orv Hetil 2010; 151:1666-71. [PMID: 20860963 DOI: 10.1556/oh.2010.28927] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Invasive lobular carcinoma--comprising approximately 10 percent of breast cancers--is considered to be a histologically, molecular genetically, clinically distinct entity metastasizing mainly the gastrointestinal tract. Gastrointestinal system is much more likely involved in advanced invasive lobular carcinoma, than it is in invasive ductal carcinoma. They manifest after 3-20 years from the recognition of the primary tumor and they appear to be inflammatory disease or a secondary tumor. Here we show the case of a female patient with breast cancer, who died at the age of 53 years. 8 years after tumor-free state upper abdominal spastic pain emerged irradiating into the back with belt-like pattern. Radiologically, Crohn's disease was diagnosed. Ileum biopsy was negative. Patient was treated ex juvantibus with methylprednisolon. In the background of mechanic ileus the resection of the terminal ileum and partly the ascended colon was surgically removed. The patient died in 3 weeks after the operation. Microscopically the thickened wall of the terminal ileum showed diffuse small cell carcinomatous infiltration. Immuno-histochemically the metastatic carcinoma cells were reacting with Breast Carcinoma Antigen (BRCA 1) and CA 15-3. The patient had AB blood group according to her red blood cell phenotype. Lectins and monoclonal antibodies with ABH blood group specificity reacted strongly with the metastatic carcinoma cells.
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Affiliation(s)
- Judit Szabó
- Kanizsai Dorottya Kórház Patológiai Osztály Nagykanizsa Szekeres J. u. 2-8. 8800
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