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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] [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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Wang S, Li W, Li S, Liu X, Zhang L, Hao C, Meng W, Zhao W, Tong Z. Clinicopathological Features and Prognosis of Gastrointestinal Metastases From Breast Carcinoma: A Clinicopathological Study of 22 Patients. Int J Surg Pathol 2023; 31:1075-1084. [PMID: 36803140 DOI: 10.1177/10668969231152583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Background. Breast carcinoma is the most common malignancy in women. Gastrointestinal metastasis is rarely found or diagnosed in patients with breast cancer. Methods. Clinicopathological features, treatment options, and prognosis were evaluated retrospectively for 22 patients with gastrointestinal metastases of breast carcinoma in Chinese women. Results. Presenting symptoms were non-specific: anorexia (21/22), epigastric pain (10/22), and vomiting (8/22), and 2 patients (2/22) presented with nonfatal hemorrhage. The first sites of metastases were skeleton (9/22), stomach (7/22), colorectal (7/22), lung (3/22), peritoneal (3/22), and liver (1/22). ER, PR, GATA binding protein 3 (GATA3), gross cystic disease fluid protein-15 (GCDFP-15), and keratin 7 can effectively confirm the diagnosis, especially in the case of keratin 20 negativity. Histology showed mainly ductal breast carcinoma (n = 11) was the predominant source of gastrointestinal metastases in this study, and lobular breast cancer (n = 9) accounted for a considerable proportion. The disease control rate to systemic therapy was 81% (17 of 21 treated patients), and the objective response rate was 10% (2 of 21 treated patients). Median overall survival was 71.5 months (range, 22-226 months), median survival for distant metastases was 23.5 months (range, 2-119 months) and the median survival for the time of gastrointestinal metastases diagnosis was 6 months (range, 2-73 months). Conclusions. Performing the endoscopy with biopsy was crucial for patients with any subtle gastrointestinal symptoms and a history of breast cancer. It is important to distinguish primary gastrointestinal carcinoma from breast metastatic carcinoma in order to select the optimal initial treatment and avoid unnecessary surgery.
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Affiliation(s)
- Shuling Wang
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Weidong Li
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Shuai Li
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xiaodong Liu
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Li Zhang
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Chunfang Hao
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Wenjing Meng
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Weipeng Zhao
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Zhongsheng Tong
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
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3
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Xu J, Liu C, Yu C, Yu T, Fan F, Zhang X, Huang C, Chen W, Sun Z, Zhou M. Breast mass as the first sign of metastasis from rectal carcinoma: a case report and review of the literature. Front Oncol 2023; 13:1211645. [PMID: 37434982 PMCID: PMC10332164 DOI: 10.3389/fonc.2023.1211645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
We present a case report of a 41-year-old woman who developed a left breast mass 18 months after undergoing Dixon rectal cancer surgery. The purpose of this case report is to highlight the possibility of breast metastases in patients with colorectal cancer and emphasize the importance of careful evaluation and follow-up as well as timely and accurate diagnosis and management of the metastatic disease. During the physical examination in 2021, we noted that the lower border of the mass was 9 cm from the anal verge and that it occupied approximately one-third of the intestinal lumen. A pathological biopsy revealed the mass in the patient's intestinal lumen was a rectal adenocarcinoma. The patient underwent Dixon surgery for rectal cancer and received subsequent chemotherapy. The patient had no prior history of breast-related medical conditions or a family history of breast cancer. During the current physical examination, we discovered multiple lymphadenopathies in the patient's left neck, bilateral axillae, and left inguinal region, but none elsewhere. We observed a large erythema of about 15x10 cm on the patient's left breast, with scattered hard nodes of varying sizes. Palpation of the area beyond the upper left breast revealed a mass measuring 3x3 cm. We conducted further examinations of the patient, which revealed the breast mass and lymphadenopathy on imaging. However, we did not find any other imaging that had significant diagnostic value. Based on the patient's conventional pathology and immunohistochemical findings, combined with the patient's past medical history, we strongly suspected that the patient's breast mass was of rectal origin. This was confirmed by the abdominal CT performed afterward. The patient was treated with a chemotherapy regimen consisting of irinotecan 260 mg, fluorouracil 2.25 g, and cetuximab 700 mg IV drip, which resulted in a favorable clinical response. This case illustrates that colorectal cancer can metastasize to unusual sites and underscores the importance of thorough evaluation and follow-up, particularly when symptoms are atypical. It also highlights the importance of timely and accurate diagnosis and management of metastatic disease to improve the patient's prognosis.
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Affiliation(s)
- Jiawei Xu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Liu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chengdong Yu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tenghua Yu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Fan Fan
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaofang Zhang
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chuansheng Huang
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wen Chen
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhengkui Sun
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Meng Zhou
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
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Sun L, Liu J, Guo M, Xu J, Wang D. First diagnosed invasive lobular carcinoma of the breast combined with gastric metastasis and bone metastasis: a case report and review of the literature. BMC Womens Health 2023; 23:133. [PMID: 36966290 PMCID: PMC10040113 DOI: 10.1186/s12905-023-02267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/08/2023] [Indexed: 03/27/2023] Open
Abstract
RATIONALE Chinese women topped the list of new breast cancers, the first diagnosed gastric metastasis and bone metastasis is extremely infrequent. The clinical and pathological diagnosis of metastatic breast cancer is difficult. To our knowledge, this is the first reported case of the first diagnosis of breast cancer with both gastric metastasis and bone metastasis. CASE REPORT The female patient was found to have abdominal distension for 15 days with nausea and vomiting. The patient underwent a gastroscopy at an outside hospital 4 days ago, showing: duodenal bulb changes, gastric retention and chronic non-atrophic gastritis. Gastroscopic biopsy showed chronic inflammation and edema of the duodenal mucosa with glandular hyperplasia. Conservative treatment was given with no relief of symptoms. She was seen in our hepatobiliary and pancreatic surgery department. After admission, palliative surgery was performed, and the swelling and surrounding involved tissues were taken for examination during surgery. The rapid pathological return could not exclude tumor lesions, and the postoperative pathology confirmed the diagnosis of invasive lobular carcinoma of the breast with gastric metastases, and the systemic examination revealed combined bone metastases. DIAGNOSIS Pathology and immunohistochemistry(IHC), a whole-body bone scan confirmed the first diagnosis of breast cancer with both gastric and bone metastases. INTERVENTIONS Palliative treatment with bisphosphonates and CDK4/6i (Palbociclib) in combination with AI (Exemestane) was administered. OUTCOMES The patient is currently under regular evaluation and is being followed up.
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Affiliation(s)
- Lin Sun
- Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China
| | - Jiajia Liu
- Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China
| | - Meng Guo
- Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China
| | - Jiaqi Xu
- Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China
| | - Dan Wang
- Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China.
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5
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Jinushi R, Sato R, Kawasaki T, Ryozawa S. A case in which immunohistochemistry was useful in the diagnosis of gastric metastasis of invasive lobular carcinoma. Oxf Med Case Reports 2023; 2023:omad021. [PMID: 36993834 PMCID: PMC10041955 DOI: 10.1093/omcr/omad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/02/2023] [Accepted: 02/18/2023] [Indexed: 03/29/2023] Open
Abstract
Metastatic breast cancer can spread to the bone, brain, liver and lung. However, metastasis to the stomach is rare. Gastric metastasis mostly presents within 10 years from the diagnosis of the primary breast cancer. We present a rare case of gastric metastasis occurring 20 years after mastectomy, diagnosed through immunohistochemistry.
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Affiliation(s)
- Ryuhei Jinushi
- Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kanagawa, Kamakura, Japan
| | - Ryo Sato
- Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomonori Kawasaki
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shomei Ryozawa
- Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
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6
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Jia J, Huang Y, Li X. Ascending colon metastasis after breast cancer surgery: a case report and literature review. Gland Surg 2023; 12:309-316. [PMID: 36915812 PMCID: PMC10005986 DOI: 10.21037/gs-22-642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
Background Breast cancer is the most common cancer in women. The tumor is prone to metastasize in the brain, lung, liver, bone, and other organs; however, generally, it is less likely to metastasize in the digestive tract. Thus, breast cancer metastasizes to colon is rarely happened and easily ignored by clinicians. Such misdiagnosis may lead to delay the further diagnosis and treatment of patients, or even cause the life danger of patients due to the progress of the disease. Therefore, we propose such case reports to arouse clinicians' attention to the rare case of digestive tract metastasis after treatment of breast cancer. We also conducted a retrospective analysis of the relevant case reports. We suggest that because breast cancer with gastrointestinal metastasis rarely occurs, and because of the lack of specificity of syndromes, it is easily misdiagnosed. Thus, the attention of the receiving doctor needs to be drawn to this tumor. We also summarized the specificity and sensitivity of the commonly used immunohistochemical detection indicators of digestive tract metastasis of breast cancer. Case Description We presented a 67-year-old female went to hospital because of "acute pain in the right lower abdomen", after computed tomography (CT) examination, the patient was diagnosed as "acute appendicitis" and underwent laparoscopic appendectomy (LA), the post-surgery pathology confirmed metastatic carcinoma to the appendix from the breast that was removed 10 years early. The patient first came to our hospital 10 years ago because of the right breast malignant tumor. After modified radical mastectomy for right breast cancer, the patient underwent chemotherapy for 6 cycles. Tamoxifen endocrine therapy was administered after chemotherapy. The patient had a regular follow-up, with no signs of distant metastasis and local recurrence. Conclusions Metastasis from breast cancer to the gastrointestinal tract is extremely rare. For patients with breast cancer, endoscopy should be adopted as a routine follow-up item. For suspicious lesions found under endoscopy, immunohistochemistry stain should be adopted to ensure the diagnosis. For lesions that are confirmed to be metastatic from breast cancer, proper treatment should be carried out based on patients' condition to improve the prognosis.
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Affiliation(s)
- Jing Jia
- Department of Gastrointestinal Surgery, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| | - Yisen Huang
- Department of Gastroenterology, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| | - Xinyu Li
- Department of Gastrointestinal Surgery, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
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7
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Yang B, Gan Z, Liu S, Si G. Synchronous isolated gastric metastases from ascending colon carcinoma: A case report. Medicine (Baltimore) 2022; 101:e32476. [PMID: 36595810 PMCID: PMC9794282 DOI: 10.1097/md.0000000000032476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Gastric metastases (GMs) are rare and often accompanied with synchronous metastases of other organs. Synchronous isolated GMs from ascending colon carcinoma are uncommon and rarely studied. GMs may be confused with primary gastric tumors. METHODS A 45-year-old man presented to our hospital with abdominal distensionand anal pendant expansion. The abdominal physical examination was negative. The positive fecal occult blood test and the negative tumor marker were obtained. Colonoscopy and gastroduodenoscopy revealed a polypoidal lesion in the ascending colon and a polypoid mass in the gastric body, respectively. CT showed the thickened wall of ascending colon and polypoid mass in the gastric body with homogenous enhancement. Additionally, synchronous gastric metastases from the ascending colon carcinoma were confirmed by pathology after laparoscopic right hemicolectomy and partial gastrectomy. After 13 individual doses of fluorouracil (2.8 g/time), calcium leucovorin (0.8 g/time), and oxaliplatin (85 mg/time), the patient was discharged without any discomfort, without any additional metastases detected during the following 18 months.1. RESULTS A rare case of synchronous isolated gastric metastasis from ascending colon carcinoma was confirmed by computed tomography (CT) and pathological diagnosis. CONCLUSION GM may appear as a polypoid lesion. Surgery combined with chemotherapy may improve the prognosis in patients with synchronous isolated GM.
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Affiliation(s)
- Bin Yang
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
- * Correspondence: Bin Yang, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China (e-mail: )
| | - Zhonghua Gan
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
| | - Shulan Liu
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
| | - Guangyan Si
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
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8
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Zhang LL, Rong XC, Yuan L, Cai LJ, Liu YP. Breast cancer with an initial gastrointestinal presentation: a case report and literature review. Am J Transl Res 2021; 13:13147-13155. [PMID: 34956535 PMCID: PMC8661181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/06/2021] [Indexed: 06/14/2023]
Abstract
The most common sites of breast cancer metastasis are the lymph nodes, lungs, bones, and liver. Gastrointestinal (GI) metastasis is relatively rare and often occurs within several years after a breast cancer diagnosis. Most patients experience abdominal pain, anorexia, bleeding, vomiting, and other digestive system symptoms, symptoms which are difficult to distinguish from primary gastric cancer. There is no characteristic change seen under a digestive tract endoscopy, and the difference in morphology under the pathological microscope from that of primary poorly differentiated gastric adenocarcinoma is so small that it can easily cause a misdiagnosis. This paper reports the case of 46-year-old female patient whose first symptom was GI discomfort. She was hospitalized for GI surgery with an unknown medical history, but, during the preoperative examination, multiple breast masses were found on both sides, which were proved by pathology to be invasive lobular cancer. According to the medical literature, bilateral breast cancer with gastric metastasis is very rare, and, so far, this is the first reported case. Despite it being a rare phenomenon, it is necessary to be aware of the possibility of metastatic lobular carcinoma in the diagnosis of poorly differentiated gastric adenocarcinoma by biopsy.
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Affiliation(s)
- Ling-Ling Zhang
- Department of Pathology, The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011, P. R. China
| | - Xiao-Cui Rong
- Department of Radiology, The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011, P. R. China
| | - Li Yuan
- Department of Endoscopy Room, The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011, P. R. China
| | - Li-Jing Cai
- Department of Pathology, The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011, P. R. China
| | - Yue-Ping Liu
- Department of Pathology, The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011, P. R. China
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9
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Sohail A, Khan A, Gross A, Shah H. Breast carcinoma metastasising to the gastric wall and the peritoneum: what physicians need to know. BMJ Case Rep 2021; 14:14/5/e241467. [PMID: 33980555 PMCID: PMC8118018 DOI: 10.1136/bcr-2020-241467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Breast cancer is the most common cancer among women in the USA and rarely metastasises to the gastric wall. We present a case of a 69-year-old woman with medical history of stage II-B breast cancer who presented with epigastric abdominal pain and black tarry stools. CT scan of the abdomen showed moderate gastric wall thickening and ascites. The patient underwent an esophagogastroduodenoscopy (EGD) with endoscopic ultrasound (EUS) for a fine-needle biopsy, which was negative for malignancy. Based on her presentation, we kept a high index of suspicion for peritoneal carcinomatosis and malignancy. The patient underwent laparoscopic wedge resection of the gastric wall with biopsies of gastric wall and peritoneum. Both biopsies confirmed the diagnosis of metastatic invasive lobular breast carcinoma. Our case highlights the importance of diagnostic laparoscopy and EUS in the setting of negative EGD biopsy results with a high suspicion of breast cancer metastasis to gastric wall.
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Affiliation(s)
- Abdullah Sohail
- West Virginia University Robert C Byrd Health Sciences Center Charleston Division, Charleston, West Virginia, USA
| | - Ahmad Khan
- West Virginia University Robert C Byrd Health Sciences Center Charleston Division, Charleston, West Virginia, USA
| | - Alexander Gross
- Pathology Resident, West Virginia University-Health Sciences Campus, Morgantown, West Virginia, USA
| | - Hamza Shah
- Assistant Professor Gastroenterology, Charleston Area Medical Center, Charleston, West Virginia, USA
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10
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Nehmeh WA, Derienne J, El Khoury L, Kassar S, Track-Smayra V, Noun R, Chakhtoura G. A 58-Year-Old Woman with Acute Gastric Perforation Due to Metastatic Ductal Carcinoma 18 Years Following Bilateral Mastectomy for Invasive Ductal Carcinoma of the Breast. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e927094. [PMID: 33828068 PMCID: PMC8042419 DOI: 10.12659/ajcr.927094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Patient: Female, 58-year-old Final Diagnosis: Gastric perforation Symptoms: Abdominal pain • peritonitis Medication: — Clinical Procedure: Jejunostomy tube placement • laparoscopic surgery • open surgery Specialty: Surgery
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Affiliation(s)
- William A Nehmeh
- Department of Digestive Surgery, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Derienne
- Department of Digestive Surgery, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Léa El Khoury
- Department of Pathology, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Serge Kassar
- Department of Digestive Surgery, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Viviane Track-Smayra
- Department of Pathology, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roger Noun
- Department of Digestive Surgery, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ghassan Chakhtoura
- Department of Digestive Surgery, Hotel Dieu De France Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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11
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Fu JX, Zou YN, Long-Li, Wang XJ. Widespread Metastasis to the Stomach 10 Years After Primary Breast Cancer: A case report and review of the literature. Medicine (Baltimore) 2020; 99:e22527. [PMID: 33235059 PMCID: PMC7710238 DOI: 10.1097/md.0000000000022527] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Breast cancer is a common malignant tumor. The most common metastatic sites of breast cancer are the bone, brain, liver and lung, and gastrointestinal metastases are rare. Considering that the median time interval from the initial breast cancer diagnosis to stomach metastasis is 77.5 months, gastrointestinal metastases are rarely observed 10 years after primary breast cancer. PATIENT CONCERNS Here, we present a 63-year-old female with unusual endoscopy results that revealed scattered polyps and mucosal infiltration throughout the stomach, which were later confirmed to be metastatic lobular carcinoma of the breast that had been surgically removed 10 years earlier. DIAGNOSIS The patient was diagnosed with gastric metastases of breast cancer by immunohistochemistry. INTERVENTIONS The patient underwent endocrine therapy with palbociclib and tamoxifen. OUTCOMES After 1 year of endocrine therapy, the symptoms of upper abdominal discomfort and fatigue were relieved and a new gastroscopy revealed there had been no significant progression of the gastric metastasis. According to the Response Evaluation Criteria in Solid Tumors (RECIST), the patient reached a state of stable disease. LESSONS Gastric metastases of breast cancer are rare in the clinical setting. However, considering the possibility of gastric metastases from breast cancer and performing an upper endoscopy are crucial for patients who present with any subtle gastric symptoms and have a past medical history of breast cancer, even if the breast cancer occurred more than 10 years ago.
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Affiliation(s)
- Ji-Xin Fu
- Department of Gastrointestinal Surgery
| | | | - Long-Li
- Department of Gastrointestinal Surgery
| | - Xin-Jian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, Shandong, China
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Bushan K, Kammar P, Singh C, Advani S, Mahajan P. Infiltrating Lobular Breast Cancer Presenting as Isolated Gastric Metastasis: a Case Report. Indian J Surg Oncol 2018; 9:318-322. [PMID: 30287990 DOI: 10.1007/s13193-017-0705-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/12/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Kirti Bushan
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Praveen Kammar
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Chandraveer Singh
- Department of Surgical Oncology, Asian Cancer Institute, Mumbai, India
| | - Suresh Advani
- Department of Medical Oncology, Asian Cancer Institute, Mumbai, India
| | - Praveen Mahajan
- Department of Pathology, Asian Cancer Institute, Mumbai, India
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Libânio D, Dinis-Ribeiro M, Pimentel-Nunes P. Gastric Metastasis of Breast Cancer after 20 Years. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2017; 25:99-101. [PMID: 29662936 DOI: 10.1159/000479233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/20/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Diogo Libânio
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Mário Dinis-Ribeiro
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Pedro Pimentel-Nunes
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
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