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Cheng M, Jia Z, Zhang G, Wang Y, Li S, Yang S, Li C, Geng C. Gastric metastasis from breast cancer: five cases and a single-institutional review. J Int Med Res 2024; 52:3000605241233988. [PMID: 38483129 PMCID: PMC10943725 DOI: 10.1177/03000605241233988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/29/2024] [Indexed: 03/18/2024] Open
Abstract
Gastric metastasis from breast cancer has a high rate of misdiagnosis and missed diagnosis. Data of patients who had gastric metastasis from breast cancer were retrieved from our hospital between 2014 and 2020. The gastric metastasis from breast cancer incidence was 0.04% (5/14,169 cases of breast cancer). Four patients had invasive lobular carcinoma, and the other patient had invasive ductal carcinoma. The time from the initial diagnosis of breast cancer to the appearance of gastric metastasis ranged from 0 to 12 years. One patient's endoscopic presentation was similar to mucosal-associated lymphoid tissue lymphoma and presented with gastric mucosal congestion and edema, widened wrinkles, mixed color fading, and redness. The initial pathological diagnosis of this patient was mucosal-associated lymphoid tissue lymphoma, and breast cancer was finally confirmed by immunohistochemistry. Hormonal receptors were highly expressed in four patients with primary and metastasis lesions and were negative in one patient. Human epidermal growth factor receptor 2 was negative in all patients. Mammaglobin and GATA3 were positive in all patients. In conclusion, the gastric metastasis of breast cancer incidence rate is low, and misdiagnosis can lead to insufficient or excessive treatment. Multiple biopsies and immunohistochemistry should be performed to diagnose gastric metastasis of breast cancer.
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Affiliation(s)
- Meng Cheng
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
- Key Laboratory in Hebei Province for Molecular Medicine of Breast Cancer, Shijiazhuang, Hebei Province, P.R. China
| | - Zhanli Jia
- Pathology Department, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Guoyu Zhang
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Yingnan Wang
- Gastroenterology Department, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Sainan Li
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
- Key Laboratory in Hebei Province for Molecular Medicine of Breast Cancer, Shijiazhuang, Hebei Province, P.R. China
| | - Shan Yang
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
- Key Laboratory in Hebei Province for Molecular Medicine of Breast Cancer, Shijiazhuang, Hebei Province, P.R. China
| | - Chunxiao Li
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Cuizhi Geng
- Breast Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
- Key Laboratory in Hebei Province for Molecular Medicine of Breast Cancer, Shijiazhuang, Hebei Province, P.R. China
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Yang SY, Zhang J, Yang ZQ, Duan JJ, Zhang Y, Li MK, Wang L, Ye CM, Nie JY. Advanced hormone receptor-positive/human epidermal growth factor receptor 2-positive invasive ductal carcinoma with cecal metastasis: A case report. Sci Prog 2023; 106:368504231201043. [PMID: 37828835 PMCID: PMC10576924 DOI: 10.1177/00368504231201043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The incidence of gastrointestinal metastases from breast cancer (BC) is low. We report a special case of Luminal B (Hormone Receptor positive [HR+]/Human Epidermal Growth Factor receptor 2-positive [HER-2+]) BC. The patient presented with asymptomatic brain metastases two years after radical surgery for modified breast cancer and developed right lower abdominal pain during relief therapy. Electronic gastroenteroscopy revealed inflammatory changes in the cecal mucosa. These changes were confirmed on pathology to be cecal metastasis from BC. The patient's condition was stabilised after treatment with an antibody-drug conjugate (ADC). For patients with BC who develop appendicitis-like symptoms after treatment for invasive ductal carcinoma of the breast, clinicians should be fully aware that the possibility of cecal metastasis needs to be considered, despite the very low probability of occurrence.
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Affiliation(s)
- Si-Yuan Yang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- Kunming Medical University, Kunming, China
| | - Ji Zhang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Zhuang-Qing Yang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- Kunming Medical University, Kunming, China
| | - Jia-Jun Duan
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Ying Zhang
- Department of Thyroid and Breast Surgery, The Third People's Hospital of Yunnan Province, Kunming, China
| | - Ming-Ke Li
- Department of Digestive Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lei Wang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Chun-mei Ye
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jian-Yun Nie
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
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Gao HF, Zhang JS, Zhang QZ, Zhu T, Yang CQ, Zhang LL, Yang M, Ji F, Li JQ, Cheng MY, Niu G, Wang K. Peritoneal Metastasis After Treated With Abemaciclib Plus Fulvestrant for Metastatic Invasive Lobular Breast Cancer: A Case Report and Review of the Literature. Front Endocrinol (Lausanne) 2021; 12:659537. [PMID: 34690920 PMCID: PMC8531720 DOI: 10.3389/fendo.2021.659537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/31/2021] [Indexed: 02/05/2023] Open
Abstract
Peritoneal metastases from invasive lobular carcinoma (ILC) of breast are uncommon and usually related to poor prognosis due to difficulty of detection in clinical practice and drug resistance. Therefore, recognizing the entities of peritoneal metastases of ILC and the potential mechanism of drug resistance is of great significance for early detection and providing accurate management. We herein report a case of a 60-year-old female who presented with nausea and vomiting as the first manifestation after treated with abemaciclib (a CDK4/6 inhibitor) plus fulvestrant for 23 months due to bone metastasis of ILC. Exploratory laparotomy found multiple nodules in the peritoneum and omentum, and immunohistochemistry confirmed that the peritoneal metastatic lesions were consistent with ILC. Palliative therapy was initiated, but the patient died two months later due to disease progression with malignant ascites. Whole exome sequencing (WES) was used to detect the tumor samples and showed the peritoneal metastatic lesions had acquired ESR1 and PI3KCA mutations, potentially explaining the mechanism of endocrine therapy resistance. We argue that early diagnosis of peritoneal metastasis from breast cancer is crucial for prompt and adequate treatment and WES might be an effective supplementary technique for detection of potential gene mutations and providing accurate treatment for metastatic breast cancer patients.
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Affiliation(s)
- Hong-Fei Gao
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun-Sheng Zhang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | | | - Teng Zhu
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ci-Qiu Yang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Liu-Lu Zhang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mei Yang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fei Ji
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jie-Qing Li
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Min-Yi Cheng
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Gang Niu
- Phil Rivers Technology, Beijing, China
| | - Kun Wang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
- *Correspondence: Kun Wang,
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Abstract
RATIONALE Breast cancer is the most commonly diagnosed malignancies in females. The most common sites of metastasis are bone, lung, liver, and brain. Gastrointestinal and adrenal gland metastasis from breast cancer are rare. Simultaneous metastases are extremely rare. Therefore, it is critically important to choose proper examination and treatment since the rapid diagnosis and primary treatment can significantly affect the survival of patients. To the best of our knowledge, this was the first case of initial dual metastasis. PATIENT CONCERNS The patient had a history of left breast cancer, and she underwent left breast-conserving surgery with sentinel lymph node biopsy 2 years ago. She was hospitalized in our center with the complaints of a stomach and lower back pain, which started suddenly and was progressively increased for half a month. DIAGNOSIS Computed tomography, gastroscopy, and immunohistochemical staining, especially GATA3 and mammaglobin, confirmed that there was simultaneous gastric and adrenal metastases. INTERVENTIONS She was eligible for the IMpassion131 clinical trials, a Phase 3 randomized, double-blind, placebo-controlled trial under treatment with atezolizumab/palcebo plus paclitaxel as adjuvant-therapy. OUTCOMES She was still undergoing the therapy and waiting for the further evaluation. LESSONS In order to better understand metastatic pathways of breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged, especially for the simultaneous rare metastatic sites. This might improve our understanding of metastatic behavior of breast cancer and promote further clinical research.
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Mosiun JA, Idris MSB, Teoh LY, Teh MS, Chandran PA, See MH. Gastrointestinal tract metastasis presenting as intussusception in invasive lobular carcinoma of the breast: A case report. Int J Surg Case Rep 2019; 64:109-112. [PMID: 31629292 PMCID: PMC6806597 DOI: 10.1016/j.ijscr.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/01/2019] [Indexed: 11/25/2022] Open
Abstract
Gastrointestinal (GI) tract metastasis in breast cancer is rare and occurs more commonly in invasive lobular carcinoma. The interval between the index breast cancer and GI tract spread may be as long as 30 years. 20% of patients with GI tract metastasis are asymptomatic, and detection may rely on physical examination and imaging. Management follows the principles of treatment in systemic disease in breast cancer, with consideration for surgery in obstruction, perforation or bleeding.
Introduction Breast cancer metastasis to the gastrointestinal (GI) tract is rare and occurs more frequently in invasive lobular carcinoma. Patients may be asymptomatic or present with variable vague symptoms that may be mistakenly attributed to side effects of chemotherapy or other benign GI diseases. Treatment follows the principles of systemic disease and includes hormonal therapy, chemotherapy and signal transduction inhibitors, with surgical intervention indicated for complications such as obstruction, perforation and hemorrhage. Presentation of case We present the case of a female patient with a history of invasive lobular breast carcinoma who had undergone mastectomy and axillary dissection, followed by chemoradiotherapy. Over the next nine years, she developed ovarian and bone metastases for which appropriate treatment was provided. A right iliac fossa mass was discovered during routine clinic review, though she remained asymptomatic. Computed tomography scan showed ileocecal intussusception. Histopathological examination of the right hemicolectomy specimen following emergency surgery confirmed metastatic invasive lobular carcinoma to the GI tract. Discussion GI tract metastasis may present 30 years after the primary breast cancer. Up to 20% of patients may be asymptomatic as shown by Montagna et al. When present, symptoms are commonly non-specific and vague. Histological diagnosis is challenging. GI metastasis typically appears as intramural infiltration of the bowel wall by small cells arranged in cords. Conclusion It is important to maintain a suspicion for GI tract metastasis in breast cancer patients who present with abdominal mass or GI symptoms, as this aids in prompt institution of accurate and appropriate management.
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Affiliation(s)
- Joanne Aisha Mosiun
- Department of General Surgery, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
| | - Muhammad Syafiq Bin Idris
- Department of General Surgery, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
| | - Li Ying Teoh
- Department of General Surgery, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
| | - Mei Sze Teh
- Department of General Surgery, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
| | - Patricia Ann Chandran
- Department of Pathology, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
| | - Mee Hoong See
- Department of General Surgery, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
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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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Falco G, Mele S, Zizzo M, Di Grezia G, Cecinato P, Besutti G, Coiro S, Gatta G, Vacondio R, Ferrari G. Colonic metastasis from breast carcinoma detection by CESM and PET/CT: A case report. Medicine (Baltimore) 2018; 97:e10888. [PMID: 29794798 PMCID: PMC6392653 DOI: 10.1097/md.0000000000010888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Metastatic spread in invasive lobular carcinoma (ILC) of breast mainly occurs in bones, gynecological organs, peritoneum, retroperitoneum, and gastrointestinal (GI) tract. Metastases to the GI tract may arise many years after initial diagnosis and can affect the tract from the tongue to the anus, stomach being the most commonly involved site. Clinical presentations are predominantly nonspecific, and rarely asymptomatic. CEA, CA 15-3, and CA 19-9 may be informative for symptomatic patients who have had a previous history of breast cancer. CASE PRESENTATION We introduce the case of asymptomatic colonic metastasis from breast carcinoma in a 67-year-old woman followed-up for Luminal A ILC. Diagnosis was performed through positron emission tomography/computed tomography (PET/CT) scan and contrast-enhancement spectral mammography (CESM), steering endoscopist to spot the involved intestinal tract and in ruling out further dissemination in the breast parenchyma. CONCLUSION In colonic metastases, tumor markers might not be totally reliable. In asymptomatic cases, clinical conditions might be underappreciated, missing local or distant recurrence. CT and PET/CT scan might be useful in diagnosing small volume diseases, and steering endoscopist toward GI metastasis originating from the breast. CESM represents a tolerable and feasible tool that rules out multicentricity and multifocality of breast localization. Moreover, particular patients could tolerate it better than magnetic resonance imaging (MRI).
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Affiliation(s)
- Giuseppe Falco
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Simone Mele
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena
| | - Graziella Di Grezia
- Radiology Department, Criscuoli Hospital, Sant’ Angelo dei Lombardi, Avellino
| | - Paolo Cecinato
- Department of Oncology and Advanced Technologies, Gastroenterology-Digestive Endoscopy Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Giulia Besutti
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena
- Department of Imaging and Medicine of Laboratory, Radiology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Saverio Coiro
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Gianluca Gatta
- Radiology Department, “Luigi Vanvitelli” University of Campania, Naples, Italy
| | - Rita Vacondio
- Department of Imaging and Medicine of Laboratory, Radiology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Guglielmo Ferrari
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
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Mistrangelo M, Cassoni P, Mistrangelo M, Castellano I, Codognotto E, Sapino A, Lamanna G, Cravero F, Bianco L, Fora G, Sandrucci S. Obstructive Colon Metastases from Lobular Breast Cancer: Report of a Case and Review of the Literature. Tumori 2018; 97:800-4. [DOI: 10.1177/030089161109700619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction Gastrointestinal metastases from breast cancer are rare. One large series reported a rate of 0.7% of gastrointestinal metastatic manifestations from breast cancer, but its true incidence could be underestimated. Here we report a case of bowel obstruction caused by sigmoid metastases from breast cancer and describe its relevance to histological origin and clinical practice. Methods The clinical course and histopathology of the case are reviewed and compared with reports of similar cases in the literature. Results An 80-year-old woman presented with bowel obstruction. Her medical history included infiltrating lobular breast cancer treated with left radical mastectomy 25 years before the current presentation; 13 years later bone metastases developed and were treated with hormone therapy. In 2003 the patient came to our emergency department because of symptoms of bowel obstruction. A computed tomography (CT) scan revealed a mass in the distal sigmoid causing the obstruction. A colostomy was performed, followed by a second operation completed with Hartmann's procedure. Histological examination revealed metastases from invasive lobular carcinoma. The patient was discharged 45 days postoperatively and died 9 months later because of disease progression. Conclusions Although gastrointestinal metastases from breast cancer are rare, patients with diagnosed breast cancer, particularly invasive lobular carcinoma, should be regularly followed up with endoscopy, CT, endosonography and PET-CT when abdominal symptoms are present. This could permit early diagnosis of gastrointestinal metastases and improve treatment planning.
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Affiliation(s)
- Massimiliano Mistrangelo
- Department of Digestive and Colorectal Surgery, Center of Minimally Invasive Surgery, University of Turin, Molinette Hospital, Turin
| | - Paola Cassoni
- Department of Biomedical Sciences and Human Oncology, University of Turin, Molinette Hospital, Turin
| | | | - Isabella Castellano
- Department of Biomedical Sciences and Human Oncology, University of Turin, Molinette Hospital, Turin
| | - Elena Codognotto
- Department of Digestive and Colorectal Surgery, Center of Minimally Invasive Surgery, University of Turin, Molinette Hospital, Turin
| | - Anna Sapino
- Department of Biomedical Sciences and Human Oncology, University of Turin, Molinette Hospital, Turin
| | - Ginevra Lamanna
- Department of Oncological Surgery, University of Turin, Molinette Hospital, Turin, Italy
| | - Francesca Cravero
- Department of Digestive and Colorectal Surgery, Center of Minimally Invasive Surgery, University of Turin, Molinette Hospital, Turin
| | - Lavinia Bianco
- Department of Oncological Surgery, University of Turin, Molinette Hospital, Turin, Italy
| | | | - Sergio Sandrucci
- Department of Oncological Surgery, University of Turin, Molinette Hospital, Turin, Italy
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Albero-González R, Gimeno-Beltrán J, Vázquez‐de las Heras I, Martínez-Orfila J, Seoane-Urgorri A, Naranjo‐Hans D, Corominas JM, Iglesias‐Coma M, Alameda‐Quitllet F. Lobular breast carcinoma with colonic metastases: A synchronous diagnosis in a 4-day period. Human Pathology: Case Reports 2017. [DOI: 10.1016/j.ehpc.2016.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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10
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Lortholary A, Humeau B, Castanié H, Zgarni-Guillaumet L, Kouri CE. [Lobular breast cancer metastasis to the colon]. Presse Med 2016; 46:126-128. [PMID: 27823909 DOI: 10.1016/j.lpm.2016.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/05/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Alain Lortholary
- Centre Catherine de Sienne, 2, rue Eric-Tabarly, 44202 Nantes, France.
| | - Benoît Humeau
- Centre hospitalier Côte-de-Lumière, service de gastro-entérologie, 4, rue Jacques-Monod, 85109 Les Sables d'Olonne, France
| | - Hélène Castanié
- Centre Catherine de Sienne, 2, rue Eric-Tabarly, 44202 Nantes, France
| | - Lemia Zgarni-Guillaumet
- Centre hospitalier Côte-de-Lumière, service de gastro-entérologie, 4, rue Jacques-Monod, 85109 Les Sables d'Olonne, France
| | - Claude El Kouri
- Centre Catherine de Sienne, 2, rue Eric-Tabarly, 44202 Nantes, France
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11
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Matsuda I, Matsubara N, Aoyama N, Hamanaka M, Yamagishi D, Kuno T, Tsukamoto K, Yamano T, Noda M, Ikeuchi H, Tomita N, Hirota S. Metastatic lobular carcinoma of the breast masquerading as a primary rectal cancer. World J Surg Oncol 2012; 10:231. [PMID: 23114188 PMCID: PMC3500710 DOI: 10.1186/1477-7819-10-231] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/18/2012] [Indexed: 12/14/2022] Open
Abstract
Background Colorectal metastasis of lobular carcinoma of the breast is a diagnostic challenge. It may macroscopically simulate primary colon cancer or inflammatory bowel disease. In some cases, the interval between the primary breast cancer and metastatic colorectal lesions is so long that the critical records for diagnosis including history might be lost or missed. Case presentation Reported herein is a case of metastatic lobular carcinoma of the breast masquerading as a primary rectal cancer developed in a 62-year-old Japanese woman. The case initially presented as a circumferential rectal lesion, and information on the patient’s history of breast cancer was not noted. As the result of endoscopic biopsy, diagnosis of poorly differentiated rectal adenocarcinoma was made. The lesion was surgically resected after chemo-radiotherapy. Histopathological examination of the resected specimen with hematoxylin and eosin (HE) stain revealed a single-file arrangement of the tumor cells, reminiscent of lobular carcinoma of the breast. Immunohistochemical analysis revealed an immunophenotype consistent with lobular carcinoma of the breast. Because further review of the patient’s history revealed an occurrence of ‘poorly differentiated adenocarcinoma of the breast’, which she had experienced 24 years earlier, the final diagnosis of the lesion was made as rectal metastasis from lobular breast carcinoma. Conclusions Poorly differentiated adenocarcinoma of the colorectum is rarer than that of the stomach. Linitis plastica-type cancer of the colorectum is also rarer than that of the stomach. A lesson from the present case is that before we conclude a linitis plastica-type cancer of poorly differentiated type as a primary colorectal cancer, it is critical to exclude a possibility of metastatic colorectal cancer.
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Affiliation(s)
- Ikuo Matsuda
- Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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12
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Ambroggi M, Stroppa EM, Mordenti P, Biasini C, Zangrandi A, Michieletti E, Belloni E, Cavanna L. Metastatic breast cancer to the gastrointestinal tract: report of five cases and review of the literature. Int J Breast Cancer. 2012;2012:439023. [PMID: 23091732 PMCID: PMC3471430 DOI: 10.1155/2012/439023] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 09/04/2012] [Indexed: 12/17/2022] Open
Abstract
Luminal gastrointestinal (GI) metastases from breast cancer are rare, reports are fragmentary and poor. The purposes of this study are to assess the gastrointestinal involvement from breast cancer in a retrospective study at a single institution and reviewing the related literature. Between January 2007 and December 2011 a total of 980 patients with breast cancer were treated at our institution, patients' records and report database were analysed. Institutional Review Board approval was obtained for this study. A search of the literature using PubMed, CancerLit, Embase, was performed. Selected for the present review were papers published in English before June 2012. Five of 980 patients (0.5%) showed gastrointestinal metastases from breast cancer, 3 patients had gastric involvement, 1 jejunum, and 1 rectum. Reviewing the literature, 206 patients affected by gastrointestinal metastasis from breast cancer were identified: the most frequent site of metastasis was the stomach (60%). The majority of the patients underwent chemotherapy and endocrine therapy, someone surgery and radiotherapy. GI metastases from breast cancer are rare, but possible, and a very late recurrence can also occur. Cyto-histological diagnosis is mandatory, to differentiate GI metastases from breast cancer to other diseases and to allow an adequate treatment.
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13
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Eljabu W, Finch G, Nottingham J, Vaingankar N. Metastatic deposits of breast lobular carcinoma to small bowel and rectum. Int J Breast Cancer 2011; 2011:413949. [PMID: 22295221 PMCID: PMC3262580 DOI: 10.4061/2011/413949] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 04/30/2011] [Accepted: 06/01/2011] [Indexed: 12/14/2022] Open
Abstract
Breast cancer is the most frequent malignancy in women accounting for approximately 32% of all cancers, with a lifetime risk of 1 in 10. It causes considerable morbidity and mortality. Recently, the survival rate has dramatically increased due to early detection of the disease and improvement in the treatment measures. However, more than 30% of the patients develop metastatic diseases following surgical treatment, radiotherapy, hormonal therapy, or chemotherapy. Distant spread is usually found in bones, lungs, liver, brain and skin. Rarely, it spreads to bowel, spleen, gallbladder, pancreas, urinary bladder, and eyes. Breast cancer is the second commonest primary tumour responsible for gastrointestinal metastases after malignant melanoma. We report a case of a Caucasian female who developed an intestinal obstruction secondary to metastatic deposits to the small bowel and later to the rectum from breast lobular carcinoma 2 years after mastectomy, axillary clearance, radiotherapy, hormonal therapy, and transverse rectus abdominis myocutaneous (TRAM) flap for reconstruction.
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Affiliation(s)
- W Eljabu
- Departments of Plastic and Reconstructive Surgery, General Surgery, and Histopathology, Northampton General Hospital, Northampton NN1 5BD, UK
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14
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Okido M, Seo M, Hamada Y, Kurihara S, Matsumoto K, Konomi H, Kato M, Ichimiya H. Metastatic breast carcinoma simulating linitis plastica of the colon: report of a case. Surg Today 2011; 41:542-5. [PMID: 21431489 DOI: 10.1007/s00595-009-4305-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 11/26/2009] [Indexed: 02/06/2023]
Abstract
A 48-year-old woman developed a mobile abdominal mass in the course of treatment for recurrent breast cancer. Imaging studies indicated linitis plastica of the colon. She underwent surgery because of the stenosis of the transverse colon. An examination of the resected specimen revealed a segmental stricture, thickening of the entire wall, and a granular mucosa resembling cobblestones. Microscopic findings of the colon lesion were very similar to those of her primary, invasive lobular carcinoma of the breast. Atypical cells showed immunoreactivity for cytokeratin-7, but not for cytokeratin-20. These findings suggested that the lesion of the colon was a colonic metastasis of breast cancer. Metastatic gastrointestinal diseases originating from breast carcinoma are unusual, and colonic metastases are especially rare. Although colon cancer may occur in patients with a history of breast cancer, metastatic colon cancer should be suspected if linitis plastica is detected.
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Affiliation(s)
- Masayuki Okido
- Department of Surgery, Hamanomachi Hospital, 3-5-27 Maizuru, Chuo-ku, Fukuoka, 810-8539, Japan
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15
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López Deogracias M, Flores Jaime L, Arias-Camisón I, Zamacola I, Murillo Guibert J, Suescun García R, Querejeta Usabiaga J, Martínez García F. Rectal metastasis from lobular breast carcinoma 15 years after primary diagnosis. Clin Transl Oncol. 2010;12:150-153. [PMID: 20156785 DOI: 10.1007/s12094-010-0481-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lobular breast carcinoma represents 2-20% of infiltrative carcinomas of the breast. The incidence of extrahepatic gastrointestinal (GI) tract metastases observed in necropsy studies varies from 6% to 18% and the most commonly affected organ is the stomach, followed by colon and rectum [1-4]. Reported herein is the case of a 67-year-old woman who was primarily diagnosed and surgically treated for a lobular carcinoma of the breast 15 years ago and is now referred with back pain and right hydronephrosis caused by a metastasis in rectum. Frequently, the absence of specific symptoms of digestive metastases of breast cancer leads to a misdiagnosis of this pathology [5-7]. The treatment will be based on a detailed clinical history and histopathological findings. Metastases from breast cancer in GI tract tumours must be excluded in a patient with previous history of breast carcinoma, as in the case reported herein.
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16
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Théraux J, Bretagnol F, Guedj N, Cazals-Hatem D, Panis Y. Colorectal breast carcinoma metastasis diagnosed as an obstructive colonic primary tumor. A case report and review of the literature. ACTA ACUST UNITED AC 2009; 33:1114-7. [PMID: 19896312 DOI: 10.1016/j.gcb.2009.05.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2009] [Revised: 05/19/2009] [Accepted: 05/20/2009] [Indexed: 12/22/2022]
Abstract
Common sites of colorectal breast carcinoma metastasis are bones, lungs, the central nervous system and the liver. Metastases in the gastrointestinal (GI) tract are rare and especially involve the stomach rather than the colon. Clinical or radiological features usually cannot differentiate them from a primary colorectal tumor, resulting in inappropriate treatment. In some cases, this lesion suggests multifocal spread of breast cancer with peritoneal carcinomatosis. Colorectal breast cancer metastasis is a rare finding and there is no consensus on the management of these lesions. The present case report describes a 69-year-old female with metastatic breast cancer presenting as an obstructive tumor of the transverse colon.
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17
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Martínez Lesquereux L, Paredes Cotoré JP, Ladra González MJ, Beiras Torrado A. [Colon metastasis of lobular breast cancer]. Cir Esp 2009; 88:122-4. [PMID: 19875107 DOI: 10.1016/j.ciresp.2009.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 08/03/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
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18
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Birla R, Mahawar KK, Orizu M, Siddiqui MS, Batra A. Caecal metastasis from breast cancer presenting as intestinal obstruction. World J Surg Oncol 2008; 6:47. [PMID: 18471290 PMCID: PMC2396163 DOI: 10.1186/1477-7819-6-47] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Accepted: 05/09/2008] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Gastrointestinal metastsasis from the breast cancer are rare. We report a patient who presented with intestinal obstruction due to solitary caecal metastasis from infiltrating ductal carcinoma of breast. We also review the available literature briefly. CASE PRESENTATION A 72 year old lady with past history of breast cancer presented with intestinal obstruction due to a caecal mass. She underwent an emergency right hemicolectomy. The histological examination of the right hemicolectomy specimen revealed an adenocarcinoma in caecum staining positive for Cytokeratin 7 and Carcinoembryonic antigen and negative for Cytokeratin 20, CDX2 and Estrogen receptor. Eight out of 11 mesenteric nodes showed tumour deposits. A histological diagnosis of metastatic breast carcinoma was given. CONCLUSION To the best of our knowledge, this is the first case report of solitary metastasis to caecum from infiltrating ductal carcinoma of breast. Awareness of this possibility will aid in appropriate management of such patients.
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Affiliation(s)
- Rashmi Birla
- Department of General Surgery, University Hospital of Hartlepool, Hartlepool, TS24 9AH, UK.
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