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Su H, Wu J, Liu H, Wei N, Lin W, Zhou Q, Wang M, Lv S, Yang Y. Review of esophageal metastasis from breast cancer. Gland Surg 2020; 9:417-422. [PMID: 32420267 DOI: 10.21037/gs.2020.04.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Esophageal metastasis of primary breast cancer is rare, with nearly all the literature on this topic consisting of case report studies. When breast cancer patients complain of progressive dysphagia after a long disease-free interval after breast surgery, they may be treated and misdiagnosed with a second primary. Our aim was to review all the literature concerning esophageal metastasis of breast cancer, for the purpose of improving the awareness in identifying these patients and providing them proper treatment.
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Affiliation(s)
- Hui Su
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing 100853, China.,Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Jing Wu
- Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Hong Liu
- Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Nan Wei
- Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Wu Lin
- Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Quan Zhou
- Department of Pathology, Capital Medical University Affiliated Beijing Shijitan Hospital, Haidian District, Beijing 100038, China
| | - Miaomiao Wang
- Department of Gastroenterology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Shuzhen Lv
- Department of Breast surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China
| | - Yunsheng Yang
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing 100853, China
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Miyake M, Yamada A, Miyake K, Endo I. Esophageal metastasis of breast cancer during endocrine therapy for pleural dissemination 21 years after breast surgery: a case report. Surg Case Rep 2019; 5:22. [PMID: 30771195 PMCID: PMC6377688 DOI: 10.1186/s40792-019-0585-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/06/2019] [Indexed: 12/19/2022] Open
Abstract
Background The esophageal metastasis of breast cancer is rare. Moreover, it is extremely unusual for patients to experience the symptoms of esophageal metastasis during their lifetimes. We present a case of dysphagia caused by esophageal metastasis after a long interval following a primary mastectomy. Case presentation A 77-year-old woman with a history of heterochronous bilateral breast cancer and under treatment for pleural dissemination recurrence originating from right breast cancer complained of dysphagia. At the age of 56, she had undergone a right radical mastectomy for right breast cancer. The histopathological findings revealed invasive ductal carcinoma, pT3N1M0, which was estrogen receptor (ER)- and progesterone receptor (PgR)-positive. At the age of 73, she underwent a second operation, a left modified radical mastectomy. The histopathological examination revealed invasive ductal carcinoma, pT1N0M0, which was negative for ER, PgR, and human epidermal growth factor receptor 2 (HER2). Four years after completion of adjuvant therapy for the left breast cancer, pleural effusion on her left side was observed and histopathological examination of a sample revealed pleural dissemination resulting from the right breast cancer. After initiation of therapy for recurrence, she developed dysphagia and, therefore, underwent an upper gastrointestinal tract endoscopic examination. The examination revealed whole circumferential stenosis and a band unstained by Lugol’s solution located 30 cm from her incisors. Examination of a biopsy specimen revealed a subepithelial luminal structure and dysplastic cells. Immunostaining was positive for CK7 and negative for CK20; furthermore, the sample was ER and PgR-positive. Considering the pathological findings, the patient was diagnosed with esophageal metastasis of her right breast cancer. Conclusions Metastatic lesions in the esophagus are often located in the submucosa; therefore, they may not be definitively diagnosed by histopathological examination of mucosal biopsy specimens. Esophageal metastasis originating from breast cancer often occurs as a part of multiple organ metastases; however, esophageal metastasis is usually not considered a prognostic factor for patients. Therefore, treatment should be determined according to the severity of the other metastatic sites and the degree of esophageal stenosis.
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Affiliation(s)
- Masuyo Miyake
- Department of Breast Surgery, Chigasaki Municipal Hospital, Honson 3-5-1, Chigasaki, Kanagawa, 253-0042, Japan.,Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Akimitsu Yamada
- Department of Breast Surgery, Chigasaki Municipal Hospital, Honson 3-5-1, Chigasaki, Kanagawa, 253-0042, Japan. .,Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
| | - Kentaro Miyake
- Department of Breast Surgery, Chigasaki Municipal Hospital, Honson 3-5-1, Chigasaki, Kanagawa, 253-0042, Japan.,Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
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Zanghì S, Siboni S, Asti E, Festa A, Bonavina L. Metastasis to the esophagus from primary adenocarcinoma of the lung. Eur Surg 2017. [DOI: 10.1007/s10353-017-0501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Breast cancer recurrence in esophagus, stomach, and liver, 15 years following primary surgery: report of a case. Int Cancer Conf J 2015. [DOI: 10.1007/s13691-014-0193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kashiwagi S, Onoda N, Asano Y, Noda S, Kawajiri H, Takashima T, Ishikawa T, Hirakawa K. A rare recurrence of bilateral breast cancer in the esophagus coincidentally associated with primary gastric cancer: a case report. J Med Case Rep 2014; 8:58. [PMID: 24533645 PMCID: PMC3930013 DOI: 10.1186/1752-1947-8-58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 12/23/2013] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Cases of esophageal metastasis of breast cancer are extremely rare. We present the case of a patient who developed recurrence as esophageal metastasis following treatment of bilateral breast cancer. Early-stage gastric cancer was also found coincidentally. CASE PRESENTATION An 86-year-old Japanese female patient with a history of bilateral breast cancer was found to have a gastric mass on a medical examination. At 72 years of age, she had undergone a total mastectomy with level II axillary lymph node dissection (pT3N0M0 stage II). Left breast cancer was found at the age of 79. A total mastectomy was performed with level II axillary lymph node dissection (pT1N0M0 stage I). At the time of her current admission, our patient complained of dysphagia. A repeat gastrofiberscopy revealed a submucosal lesion in her middle esophagus, located 27cm distal to her incisors, as well as a known type I tumor of the gastric cardia. Computed tomography showed a mass lesion in her middle esophagus that had grown extraluminally and infiltrated the tracheal bifurcation and her left primary bronchus. A boring biopsy of the esophageal lesion was performed under ultrasonic monitoring, and a pathological diagnosis of poorly differentiated adenocarcinoma of the esophagus was obtained. The biopsy of the cardiac lesion revealed moderately differentiated adenocarcinoma of the stomach. The expression status of her hormone receptors indicated that the esophageal lesion reflected metastatic recurrence of her breast cancer with coincidental primary gastric cancer (cT1N0M0 stage IA). CONCLUSIONS Esophageal metastasis of breast cancer is extremely rare. An individualized treatment plan combining multimodal approaches should therefore be devised according to the patient's status.
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Affiliation(s)
- Shinichiro Kashiwagi
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Naoyoshi Onoda
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Yuka Asano
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Satoru Noda
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Hidemi Kawajiri
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Tsutomu Takashima
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Tetsuro Ishikawa
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Kosei Hirakawa
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
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