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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] [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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Duodenal Obstruction as First Presentation of Metastatic Breast Cancer. Case Rep Surg 2015; 2015:605719. [PMID: 26266075 PMCID: PMC4523720 DOI: 10.1155/2015/605719] [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: 02/11/2015] [Revised: 07/10/2015] [Accepted: 07/13/2015] [Indexed: 02/07/2023] Open
Abstract
The metastatic breast cancer to the duodenum is rare in spite of common breast cancer. In this paper, we are reporting a rare case of 50-year-old lady who presented with intestinal obstruction as result of metastatic breast cancer which completely responds to chemotherapy. The tumor presents again as brain metastasis after stop of Herceptin due to cardiac toxicity.
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Unexpected diagnosis of both adenocarcinoma of the colon and metastatic lobular carcinoma of the breast in the gastrointestinal tract. Case Rep Pathol 2013; 2013:153180. [PMID: 23984147 PMCID: PMC3741921 DOI: 10.1155/2013/153180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/30/2013] [Indexed: 12/26/2022] Open
Abstract
Breast cancer rarely metastasises to the gastrointestinal tract. Lobular carcinoma more commonly metastasises to the uterus and appendages, peritoneum, and gastrointestinal tract than other types of breast cancer, while ductal carcinoma has a propensity to metastasise to the lungs, liver, and brain. We describe the case of a patient with no known history of breast cancer, whose primary presentation of lobular breast cancer was with malignant small intestinal and colonic strictures, with coexisting previously undiagnosed adenocarcinoma of the colon.
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Calò PG, Fanni D, Ionta MT, Medas F, Faa G, Atzori F. Jejunal Obstruction Caused by Metastasis from an Undiagnosed Breast Cancer: A Case Report. TUMORI JOURNAL 2012. [DOI: 10.1177/030089161209800327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Solitary metastasis from breast carcinoma to the gastrointestinal tract is an uncommon finding. We describe a female patient with a solitary jejunal metastasis from an undiagnosed breast cancer who presented to the emergency department with a bowel obstruction. Abdominal surgery was performed, revealing a jejunal stenosis from a metastatic lobular carcinoma. The primary tumor in the left breast was subsequently diagnosed and surgically removed.
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Affiliation(s)
- Pietro Giorgio Calò
- Dipartimento di Chirurgia e Scienze
Odontostomatologiche, Università degli Studi di Cagliari, Cagliari, Italy
| | - Daniela Fanni
- Unità operativa Complessa di Anatomia
Patologica, AOU Cagliari, Università degli Studi di Cagliari, Cagliari, Italy
| | - Maria Teresa Ionta
- Unità operativa Complessa di Oncologia
Medica II, AOU Cagliari, Università degli Studi di Cagliari, Cagliari, Italy
| | - Fabio Medas
- Dipartimento di Chirurgia e Scienze
Odontostomatologiche, Università degli Studi di Cagliari, Cagliari, Italy
| | - Gavino Faa
- Unità operativa Complessa di Anatomia
Patologica, AOU Cagliari, Università degli Studi di Cagliari, Cagliari, Italy
| | - Francesco Atzori
- Unità operativa Complessa di Oncologia
Medica II, AOU Cagliari, Università degli Studi di Cagliari, Cagliari, Italy
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Razzetta F, Tassara E, Saro F, Sironi M, D'Ambrosio G. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg 2011; 63:129-33. [PMID: 21286894 DOI: 10.1007/s13304-011-0047-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/14/2011] [Indexed: 02/08/2023]
Abstract
Intra-abdominal metastases from breast carcinomas are rarely reported in the literature. Least are those originating from occult breast primary. We report, one case of pancreatic metastasis and one case of metastatic infiltration of the colonic wall, both by occult lobular breast carcinoma. The first patient underwent pancreaticoduodenectomy for obstructive jaundice, with unexpected histological finding of infiltration of distal bile duct, pancreatic gland, portal vein and retroperitoneal soft tissue by lobular carcinoma of the breast. The second patient complained of diffuse abdominal pain associated with constipation and rectal bleeding and underwent endoscopic biopsy of three intestinal strictures, revealing metastatic lobular carcinoma with signet-ring cell morphology. In both cases, a subsequent complete diagnostic work-up demonstrated asymptomatic multiple breast nodules, diagnosed as lobular carcinoma by fine needle aspiration cytology.
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Affiliation(s)
- Francesco Razzetta
- Anatomia Patologica, Ospedale di Sestri Levante, Via Terzi 43/a, 16039 Sestri Levante (Genoa), Italy
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Dumoulin FL, Sen Gupta R. Breast cancer metastasis to the stomach resembling small benign gastric polyps. Gastrointest Endosc 2009; 69:174-5. [PMID: 18582874 DOI: 10.1016/j.gie.2008.03.1082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 03/17/2008] [Indexed: 01/27/2023]
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