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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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2
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Schellenberg AE, Wood ML, Baniak N, Hayes P. Metastatic ductal carcinoma of the breast to colonic mucosa. BMJ Case Rep 2018; 2018:bcr-2018-224216. [PMID: 29804074 DOI: 10.1136/bcr-2018-224216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Breast cancer is the most common malignancy among women, while invasive ductal carcinoma is the most common type of invasive breast cancer. Metastatic spread to the colon and rectum in breast cancer is rare. This report describes a case of a 69-year-old woman with metastatic ductal breast cancer to the rectosigmoid, presenting as an incidental finding on screening colonoscopy. The breast carcinoma was first diagnosed 2 years prior. Colonic biopsies from colonoscopy confirmed metastatic adenocarcinoma consistent with a breast primary. Ultimately her clinical condition worsened as she developed malignant ascites, a small bowel obstruction, and new bone metastases, and the patient succumbed to her illness. Cases of metastatic breast cancer to the gastrointestinal tract have predominantly been lobular breast carcinoma. Increased awareness of colonic metastasis may lead to more accurate diagnosis and earlier systemic treatment.
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Affiliation(s)
- Angela E Schellenberg
- Department of General Surgery, Selkirk Regional Health Centre, Selkirk, Manitoba, Canada
| | - Melissa Lillian Wood
- Department of Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Nick Baniak
- Department of Pathology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Paul Hayes
- Department of Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
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3
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Raigoso P, Sanz L, Vizoso F, Llana B, Roibás A, Vérez P, García-Muñiz IL. Estrogen and Progesterone Receptors in Colorectal Cancer and Surrounding Mucosa. Int J Biol Markers 2018; 16:262-7. [PMID: 11820722 DOI: 10.1177/172460080101600407] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this prospective study we have quantified by means of ELISA-methods the cytosolic content of estrogen (ER) and progesterone receptors (PgR) in tumoral tissue and paired normal mucosa from 163 patients with resectable colorectal cancer. Survival analysis was performed in a subgroup of 120 patients and the mean follow-up period was 24.9 months. The cutoff for ER and PgR levels was set at 1 fmol/mg protein. On the basis of this cutoff 20.9% of the cancers were ER positive and 25.8% were PgR positive; normal adjacent tissue presented ER in 18.4% and PgR in 24.5%. Our results did not show any significant correlation between ER and PgR levels in neoplastic tissues. Howewer, a correlation was found in normal mucosa samples (p=0.02). Statistical analysis showed that there was no correlation between tumor ER and PgR content and patient age or sex, tumor location, Dukes’ stage, histological differentiation, DNA ploidy status and S-phase fraction. Furthermore, the results did not show any statistical differences in relapse-free and overall survival curves calculated for patients classified according to the hormone receptor content of their tumors. ER and PgR were detected at low levels in normal and neoplastic colorectal tissues without any significant relationship to either clinicopathological tumor characteristics or patient outcome. Their possible role in colorectal cancer remains to be elucidated.
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Affiliation(s)
- P Raigoso
- Department of Nuclear Medicine, Hospital Central de Asturias, Oviedo, Spain
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Thomas GP, dos Santos IM, Ouro SM, Thomas-Gibson S, Vaizey CJ. Colorectal disorders during pregnancy: a review. Br J Hosp Med (Lond) 2013; 74:625-30. [PMID: 24220524 DOI: 10.12968/hmed.2013.74.11.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G P Thomas
- Research Fellow, Sir Alan Parks Department of Physiology, St Marks Hospital and Academic Institute, Harrow
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5
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Ho MY, Cassano-Bailey A, Czaykowski P. Colorectal Cancer in Pregnancy: Driven by Pregnancy-Associated Growth Factors? J Gastrointest Cancer 2012; 43 Suppl 1:S239-42. [DOI: 10.1007/s12029-012-9394-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Puglisi M, Varaldo E, Assalino M, Ansaldo G, Torre G, Borgonovo G. Anal metastasis from recurrent breast lobular carcinoma: A case report. World J Gastroenterol 2009; 15:1388-90. [PMID: 19294770 PMCID: PMC2658842 DOI: 10.3748/wjg.15.1388] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later, she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis. According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.
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Uygun K, Kocak Z, Altaner S, Cicin I, Tokatli F, Uzal C. Colonic metastasis from carcinoma of the breast that mimics a primary intestinal cancer. Yonsei Med J 2006; 47:578-82. [PMID: 16941751 PMCID: PMC2687742 DOI: 10.3349/ymj.2006.47.4.578] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although the lung, liver, or bones are the most common location for distant metastases in breast cancer patients, metastases to the intestinal tract are very rarely recognized in the clinic. We will present an unusual case of colonic metastasis from a carcinoma of the breast that mimics a primary intestinal cancer, along with a through review of English language medical literature. Despite the fact that isolated gastrointestinal (GI) metastases are very rare and much less common than benign disease processes or second primaries of the intestinal tract in patients with a history of breast cancer, metastatic disease should be given consideration whenever a patient experiences GI symptoms.
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Affiliation(s)
- Kazim Uygun
- Department of Medical Oncology, Trakya University Hospital, 22030 Edirne, Turkey.
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Vaidya JS, Mukhtar H, Bryan R. Colonic metastasis from a breast cancer--a case report and a few questions. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2002; 28:463-4. [PMID: 12099661 DOI: 10.1053/ejso.2002.1278] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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9
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Abstract
Existing data suggest that there is a hormonal basis to the cause of colon cancer. In the present study, we evaluated the presence of estrogen receptors (ERs) and progesterone receptors (PRs) in colonic tumors from 156 women diagnosed with colon cancer in Utah from September 1991 through September 1994. Immunohistochemical staining with antibodies to ERs and PRs was performed on histologic sections prepared from paraffin blocks. None of the tumors were considered ER-positive; 1 tumor was PR-positive. Use of hormone replacement therapy was not associated with PR-positive tumors. These data do not support previous reports that suggest that colon tumors frequently have receptors for estrogen, progesterone, or both.
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Affiliation(s)
- M L Slattery
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA
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10
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Abstract
In vivo and epidemiological data suggest a mitogenic role for estrogens (E) in colon cancer. The presence of estrogen receptor (ER) and ER mRNA in colonic epithelium and colon cancer cells, make it necessary to explore the possible direct effects of E on colon cancer growth. In this study, a 15-mer oligodoxynucleotide (oligo) antisense to the region of the translation start codon of estrogen receptor mRNA inhibited ER expression in a mouse colon cancer cell line (MC-26), as determined by receptor binding assay. Antisense oligo also decreased ER mRNA levels in MC-26 cells. The growth-stimulatory effect of E was abolished by antisense oligo treatment, demonstrating that the ER is directly involved in the regulation of colon cancer cell growth.
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MESH Headings
- Adenocarcinoma/chemistry
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Animals
- Antineoplastic Agents/pharmacology
- Base Sequence
- Blotting, Northern
- Cell Division/physiology
- Colonic Neoplasms/chemistry
- Colonic Neoplasms/genetics
- Colonic Neoplasms/pathology
- Estradiol/analogs & derivatives
- Estradiol/pharmacology
- Estrogen Antagonists/pharmacology
- Estrogens/metabolism
- Estrogens/pharmacology
- Fulvestrant
- Mice
- Molecular Sequence Data
- Oligonucleotides, Antisense/analysis
- Oligonucleotides, Antisense/chemistry
- Oligonucleotides, Antisense/genetics
- RNA, Messenger/analysis
- RNA, Messenger/chemistry
- RNA, Messenger/genetics
- Receptors, Estrogen/analysis
- Receptors, Estrogen/genetics
- Receptors, Estrogen/physiology
- Tamoxifen/pharmacology
- Tumor Cells, Cultured
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Affiliation(s)
- X Xu
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston 77555
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Hendrickse CW, Jones CE, Donovan IA, Neoptolemos JP, Baker PR. Oestrogen and progesterone receptors in colorectal cancer and human colonic cancer cell lines. Br J Surg 1993; 80:636-40. [PMID: 8518910 DOI: 10.1002/bjs.1800800531] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Receptors for oestrogen (ER) and progesterone (PR) were assayed in tissue from 17 patients with colorectal cancer and five colonic cancer cell lines using enzyme immunoassays. ERs and PRs were detected in 15 and 17 cancers respectively, although the levels detected were low: median (range) ER 1.3 (0-11.3) and PR 3.9 (0.3-10.2) fmol per mg protein. These values were not significantly different from median (range) levels of ER (1.1 (0.6-3.0) fmol/mg) and PR (1.9 (0.5-3.2) fmol/mg) detected in normal mucosa. There were significant positive correlations between the levels of ER and PR for cancer tissue (tau = 0.56, P < 0.005; r(log transform) = 0.68, P < 0.003; n = 17) but not for mucosa, and between levels of ER in cancer tissue and mucosa (tau = 0.55, P < 0.05; r(log transform) = 0.70, P < 0.025; n = 10) but not between the corresponding PR values. In maintenance media, which contained phenol red and unstripped fetal calf serum, the median (range) concentration of ER was 1.9 (1.2-10.4) fmol/mg and that for PR 24.3 (9.1-63.2) fmol/mg in the five cell lines studied (HT-29, LS174T, SW620, LoVo, COLO 320DM). The addition of oestradiol (10 nmol/l) to phenol red-free medium containing 5 per cent dextran-coated charcoal-treated fetal calf serum had little effect on the concentration of ERs or PRs in SW620, LoVo and COLO 320DM cells after 7 days' culture. It is concluded that ERs and PRs are expressed in malignant and normal colonic mucosa. ERs appear to be a feature of the colonic mucosa rather than the malignant process, but in carcinoma may regulate synthesis of PRs, suggesting a degree of oestrogen responsiveness.
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12
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Abstract
This article will present an overview of estrogen and progestin action at a cellular level, with emphasis on points that are relevant to neoplasia. In breast, endometrium and ovary, these two classes of hormone are clearly implicated in carcinogenesis, but their involvement with cancers of the liver, cervix and other tissues is more problematic. In the latter situations, I will highlight the major points to be considered if the hormones are involved without wishing to judge whether there actually is a causal involvement.
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Affiliation(s)
- R J King
- Biochemistry Department, University of Surrey, Guildford, United Kingdom
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