1
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
2
|
Zhang H, Zhang L, Qiao Y. Secondary esophageal adenocarcinoma of pulmonary origin: a case description of imaging findings. Quant Imaging Med Surg 2022; 12:4331-4336. [PMID: 35919048 PMCID: PMC9338356 DOI: 10.21037/qims-22-84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/01/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Huaiyu Zhang
- Department of Radiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lirong Zhang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuangang Qiao
- Department of Radiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
3
|
Balázs Á, Vass T, Baranyai Z. Esophageal Strictures due to Mediastinal Metastases from Breast Cancer. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AbstractMediastinal metastases represent an infrequent recurrence of breast carcinoma. Esophageal involvement by metastatic tissue is extremely rare. The situation means an unusual diagnostic and therapeutic challenge. Dignity of esophageal stricture is difficult to ascertain; endoscopy and picture giving methods might be conflicting. This study aimed to analyze the clinical characteristics and the therapeutic possibilities of the condition. A retrospective analysis of malignant esophageal stricture cases was performed from a prospectively collected database between 1984 and 2020. Out of 3996 cases with esophageal malignancy, 17 esophageal strictures were confirmed to be related to breast cancer metastasis. Surgical resection was feasible in 3 cases; endoprosthesis insertion was performed for palliation in 7 cases, and in 7 cases, only supportive care was available. Our incidence rate was 0.43%. Dysphagia indicating an affected esophagus presented on average 10.5 years after the primary tumor surgery. Mean duration between onset of symptoms achieving appropriate diagnosis was 6.4 months. Dignity of the malignancy was confirmed only retrospectively in one case. Morphologic findings showed an external esophageal compression in 52.9%, while in 35.3%, a destructive tumor growth affecting the mucosal layer could be found. Overall, survival was 7.6 months referring to 15 cases. The possible occurrence of mediastinal metastases involving the esophagus should be seriously considered in patients with previous breast cancer history. Biopsies obtained from the intact mucosal surface of the stenotic esophagus are often inefficient and misleading; therefore, repeated biopsies are necessary. Options for radical surgery are highly limited.
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|