Metastatic breast adenocarcinoma masquerading as colonic primary. Report of two cases

BACKGROUND

Common sites of metastasis for the breast cancer are bones, lungs, the central nervous system and liver. The colon is the rarest site of metastasis for the breast carcinoma.

PATIENTS AND RESULTS

We report our recent experience of two female patients, 55 and 57 years old respectively, who presented breast metastasis at the proximal transverse colon. They were operated for breast carcinoma followed by chemotherapy and radiotherapy, four and ten years before the metastasis was diagnosed. The symptoms were anaemia and bowel obstruction. Diagnosis was made by double contrast barium enema and colonoscopy. Postoperatively, both patients received systemic chemotherapy. At the follow-up, two and three years after, there is no evidence of recurrence or metastasis.

CONCLUSIONS

Patients with history of breast cancer presenting with anaemia and/or bowel obstruction should be examined for possible metastasis to colon and should be treated surgically followed by systemic chemotherapy.

Colorectal gastrointestinal mesenchymal tumours. Report of a stromal case of the rectum (GIST) and a leiomyosarcoma of the transverse colon

BACKGROUND

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract. They are positive to C-kit (CD 117), more common in the older males, and mostly in the stomach, less in the colon and rectum and oesophagus. Benign tumours are more common than the malignant ones. Classification of GISTs is based on morphology and immunochemistry.

METHODS

We report two cases of colorectal gastrointestinal mesenchymal tumours, one on the transverse colon which was found to be immunohistochemically leiomyosarcoma and the other on the rectum which met the GIST criteria. The patients underwent transversectomy and abdominal perineal resection, respectively.

CONCLUSIONS

They did not receive Imanitib postoperatively and two years after there is no evidence of recurrence. Surgery is the treatment of choice for resectable GISTs, and other mesenchymal tumours benign or malignant.