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Bendimya M, Kairouani M, El Magroud M, Bennani A, Al Jarroudi O, Brahmi SA, Afqir S. Unusual Metastasis of Gastric Signet Ring Cell Carcinoma to the Breast: A Case Report of a Young Moroccan Patient. Cureus 2024; 16:e56333. [PMID: 38629003 PMCID: PMC11021129 DOI: 10.7759/cureus.56333] [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] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
Although gastric cancer is known to be an aggressive tumor that can spread throughout the body, breast metastases are uncommon. This entity is rarely reported in the literature, with an estimated incidence of 0.5 to 1.3%. We report a case of a rare association between a gastric subtype of signet ring cell carcinoma and metastasis to the breast. This uncommon situation is only documented through case reports. Most breast metastases have been detected after diagnosis of primary gastric cancer, during the first year. Several risk factors have been suggested to explain the aggressive behavior of these tumors, which correlates with very poor prognosis and short survival. We report the case of a 22-year-old female patient presenting with widespread metastatic gastric signet ring cell carcinoma with an unusual secondary site in the breast. The diagnosis was confirmed by immunohistochemistry (IHC) and radiology, and the patient was treated with palliative chemotherapy in accordance with the decision of the multidisciplinary tumor board.
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Affiliation(s)
- Mohammed Bendimya
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Oujda, MAR
- Medical Oncology, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR
| | - Mouna Kairouani
- Medical Oncology, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR
| | | | - Amal Bennani
- Anatomopathology, Faculty of Medicine and Pharmacy of Oujda, Oujda, MAR
| | - Ouissam Al Jarroudi
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Oujda, MAR
- Medical Oncology, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR
| | - Sami Aziz Brahmi
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Oujda, MAR
- Medical Oncology, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR
| | - Said Afqir
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Oujda, MAR
- Medical Oncology, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR
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2
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Vaidya T, Ramani S, Rastogi A. A case series of metastases to the breast from extramammary malignancies. Indian J Radiol Imaging 2021; 28:470-475. [PMID: 30662213 PMCID: PMC6319108 DOI: 10.4103/ijri.ijri_218_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Metastases to the breast from extra-mammary malignancies are extremely uncommon. The discovery of a breast mass in a patient with a known primary tumor elsewhere poses a diagnostic challenge to the clinician. An awareness of the various malignancies that can metastasize to the breast and accurate diagnosis of the same is essential to avoid an unnecessary mastectomy and to guide further therapy. In this case series, we describe such clinical scenarios with an emphasis on the imaging features of metastases to the breast, which will enable radiologists to recognize this entity with greater ease.
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Affiliation(s)
- Tanvi Vaidya
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
| | - Subhash Ramani
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
| | - Ashita Rastogi
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
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3
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Nidhamalddin SJ, Hassan HA, Ali K, Ghareeb KAH, Gubari MIM. Breast cancer metastasis from Gastric Carcinoma in a young female. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2019. [DOI: 10.29333/ejgm/115858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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4
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Ma Y, Liu W, Li J, Xu Y, Wang H. Gastric cancer with breast metastasis: Clinical features and prognostic factors. Oncol Lett 2018; 16:5565-5574. [PMID: 30344710 PMCID: PMC6176254 DOI: 10.3892/ol.2018.9383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/22/2018] [Indexed: 11/10/2022] Open
Abstract
Metastatic spread of gastric carcinoma to the breast is rare. In previous decades, reports on this subject were minimal and primarily limited to case reports. At present, little is known on the clinicopathological features and prognosis of this condition, and breast metastasis remains a challenging clinical problem. A total of 54 cases of breast metastasis from gastric cancer were collected from databases between January 1960 and December 2016. The present study included 3 cases of gastric cancer with breast metastasis from Renji hospital and 51 additional cases from previous studies. The clinicopathological features of patients, including epidemiology, symptoms, macroscopic presentation, pathological diagnosis, imaging, treatment and overall survival time, were analyzed. The median survival time was 8.6 months. All but one of the patients were female, and the median age at diagnosis of breast metastasis was 43 years old (age range, 22–72 years). A majority of patients presented with Borrmann class III disease, signet ring cell carcinoma, T4 tumor types, lymph node involvement, initial stage IV gastric cancer, primary lesions in the gastric antrum, left breast metastasis and palpable breast nodules. The median interval between the primary gastric carcinoma diagnosis and presentation of breast metastasis was 1.25 months (range, 0–72 months). The expression of the estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 and gross cystic disease fluid protein-15 was negative in the patients with breast metastases. In univariate analysis, age, gastric tumor size, gastric lymph node involvement and breast metastasis histology were significantly associated with overall survival (OS) time (P=0.001, 0.039, 0.034 and <0.001, respectively). Therapeutically, gastric surgery and chemotherapy were not associated with OS (P=0.959 and 0.290, respectively). In further multivariate analysis, the time between occurrence (P=0.017), age (P=0.009), histology (P=0.045) and breast metastasis localization (P=0.043) were independent indicators of OS time. Although breast metastasis from gastric cancer is rare, physicians should be vigilant when patients with a history of gastric cancer present with newly developed mammary symptoms and signs.
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Affiliation(s)
- Yue Ma
- Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P.R. China
| | - Wenwen Liu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P.R. China
| | - Junjian Li
- Department of Oncology, General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, P.R. China
| | - Yingchun Xu
- Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P.R. China
| | - Hongxia Wang
- Department of Oncology, General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, P.R. China
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5
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Kubo H, Shimizu T, Sekido H, Matsuda G, Takeda K, Watanabe A, Sakamoto R, Yamamoto Y, Toyoda J, Niino H. Isolated breast metastasis from gastric cancer in a male patient. Clin J Gastroenterol 2018; 11:138-144. [PMID: 29302921 DOI: 10.1007/s12328-017-0815-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 12/25/2017] [Indexed: 12/01/2022]
Abstract
A 72-year-old man underwent total gastrectomy for gastric cancer (por2, T3, N2, Stage IIIA). Eleven courses of postoperative chemotherapy with TS-1 (tegafur/gimeracil/oteracil) were administered. Five months after surgery, the serum carcinoembryonic antigen value was slightly elevated. However, computed tomography did not reveal any metastatic lesions in other organs. Two years after surgery, the patient felt a mass in the left mammary. A 2-cm tumor was palpable in the central portion of the breast. Ultrasonography revealed a hypoechoic tumor, which was Class 3 on aspiration biopsy cytological examination. No mass was detected on positron emission tomography-computed tomography. The mammary gland tumor increased in size to 3 cm, and a core needle biopsy procedure was performed. Histological examination findings revealed breast metastasis of gastric cancer. No other recurrence was found, and radical mastectomy was performed 2 years and 5 months after gastrectomy. Immunohistological analysis of the resected material confirmed breast metastasis of the gastric cancer. Two courses of TS-1 + cisplatin were administered, but this treatment was subsequently terminated because the patient experienced Grade 3 diarrhea and neutropenia. Three years and 1 month after the gastrectomy, the tumor recurred in the pelvic area. Chemotherapy and radiation therapy were performed, but the patient's overall condition became progressively worse, and he died 3 years and 9 months after gastrectomy.
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Affiliation(s)
- Hirokazu Kubo
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan.
| | - Tetsuya Shimizu
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Hitoshi Sekido
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Goro Matsuda
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Kazuhisa Takeda
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Akira Watanabe
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Risa Sakamoto
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Yuji Yamamoto
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Junya Toyoda
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
| | - Hitoshi Niino
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Harajuku 3-60-2, Totsuka, Yokohama, Kanagawa, 245-8575, Japan
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Kalli S, Lanfranchi M, Alexander A, Makim S, Freer PE. Spectrum of Extramammary Malignant Neoplasms in the Breast With Radiologic-Pathologic Correlation. Curr Probl Diagn Radiol 2015; 45:392-401. [PMID: 26416136 DOI: 10.1067/j.cpradiol.2015.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/13/2015] [Accepted: 07/28/2015] [Indexed: 01/07/2023]
Abstract
Although primary breast cancer is the most common malignancy identified by breast imaging, extramammary malignancies may also rarely be encountered. These uncommon lesions may reflect primary neoplasms of nonmammary origin as well as secondary metastatic lesions, and include lymphoma, melanoma, neuroendocrine tumors, gastrointestinal tract malignancies, and angiosarcoma among other entities. Malignant extramammary breast lesions may be encountered during routine mammographic screening, identified during the diagnostic evaluation of a palpable breast abnormality, or may be detected incidentally during imaging of other organs of interest. As such, the radiologist should have familiarity with the appearance of these lesions. This article focuses on a review of several of the most common extramammary metastases to the breast, as well as a few lesions that may develop as either primary or secondary lesions.
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Affiliation(s)
- Sirishma Kalli
- Department of Radiology, Tufts Medical Center, Boston, MA.
| | | | | | - Shital Makim
- Department of Radiology, Tufts Medical Center, Boston, MA
| | - Phoebe E Freer
- Avon Comprehensive Breast Center, Massachusetts General Hospital, Boston, MA
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7
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He CL, Chen P, Xia BL, Xiao Q, Cai FL. Breast metastasis of gastric signet-ring cell carcinoma: a case report and literature review. World J Surg Oncol 2015; 13:120. [PMID: 25890325 PMCID: PMC4386101 DOI: 10.1186/s12957-015-0538-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/07/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cases of primary gastric adenocarcinoma with metastasis to the breast are extremely rare. Till now, only 38 cases have been reported in PubMed since 1908. Case presentation We herein reported a race case of gastric adenocarcinoma with metastasis to the right breast. Breast biopsy showed invasive signet-ring cell breast carcinoma in the right breast. She was given a TEC regimen (docetaxel 75 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 600 mg/m2 every 3 weeks) for one cycle but showed no objective response. Upper gastrointestinal endoscopy demonstrated an ulcerative mass in the gastric body. Biopsy demonstrated low-grade gastric adenocarcinoma with signet-ring features. In immunohistochemistry, mammary malignant cells were positive for cytokeratin 7, cytokeratin 20, villin, and ErbB2/HER2, but negative for gross cystic disease fluid protein-15, estrogen receptor, and progesterone receptor. The diagnosis of metastatic poorly differentiated signet-ring cell adenocarcinoma of the right breast identical to gastric primary was confirmed finally. Conclusions Gastric cancer with metastasis to the breast can be diagnosed by clinical history, histological findings, and immunohistochemical markers.
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Affiliation(s)
- Chun-Lan He
- Department of Thyroid and Breast Surgery, Subei People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu Province, China.
| | - Ping Chen
- Department of Gastrointestinal Surgery, Subei People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu Province, China.
| | - Bing-Lan Xia
- Department of Ultrasonography, Subei People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu Province, China.
| | - Qin Xiao
- Department of Pathology, Subei People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu Province, China.
| | - Feng-Lin Cai
- Department of Thyroid and Breast Surgery, Subei People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu Province, China.
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8
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Iesato A, Oba T, Ono M, Hanamura T, Watanabe T, Ito T, Kanai T, Maeno K, Ishizaka K, Kitabatake H, Takeuchi D, Suzuki A, Nakayama J, Ito KI. Breast metastases of gastric signet-ring cell carcinoma: a report of two cases and review of the literature. Onco Targets Ther 2014; 8:91-7. [PMID: 25565869 PMCID: PMC4284042 DOI: 10.2147/ott.s67921] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
It is occasionally difficult to diagnose breast metastasis of gastric carcinoma because of its rarity. However, to appropriately treat patients with breast tumors without delay, it is important to distinguish metastatic cancer from primary breast cancer. We report two cases of breast metastasis of gastric carcinoma and review the literature. The first case was a 41-year-old female diagnosed with bilateral pelvic tumors who visited the outpatient clinic because of pain and enlargement of both breasts. Ultrasonography showed diffuse hypoechoic lesions, which were enhanced on gadolinium-enhanced magnetic resonance imaging in the bilateral mammary gland. Core needle biopsy of the right breast revealed signet-ring cells, which were also identified in the resected bilateral pelvic tumors. Subsequent upper gastrointestinal endoscopy revealed signet-ring cell carcinoma in the stomach, and the bilateral breast lesions were diagnosed as metastases of gastric carcinoma. The second case was a 34-year-old female diagnosed with cervical metastasis of signet-ring cell carcinoma who was referred to the breast cancer clinic because of a nodule in the left breast detected by computed tomography. Ultrasonography showed a hypoechoic nodule that was enhanced on gadolinium-enhanced magnetic resonance imaging. Because the pathologic findings for the left breast nodule were quite similar to those of gastric cancer and its cervical metastasis, the breast nodule was diagnosed as a metastasis of gastric carcinoma. When a breast tumor is suspected to have metastasized from a primary tumor in another organ, particularly if signet-ring cells are found, the possibility that gastric cancer is present should be considered.
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Affiliation(s)
- Asumi Iesato
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takaaki Oba
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Mayu Ono
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toru Hanamura
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takayuki Watanabe
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tokiko Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toshiharu Kanai
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazuma Maeno
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | - Daisuke Takeuchi
- Department of Gastrointestinal Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Akira Suzuki
- Department of Gastrointestinal Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Jun Nakayama
- Department of Molecular Pathology, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Ken-Ichi Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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9
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Hebbar AK, Shashidhar K, S KM, Kumar V, Arjunan R. Breast as an unusual site of metastasis- series of 3 cases and review of literature. Indian J Surg Oncol 2014; 5:189-93. [PMID: 25419063 DOI: 10.1007/s13193-014-0333-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022] Open
Abstract
Background and objectives Metastasis to the breast from extra mammary sites is uncommon with an incidence ranging from 1.2 to 2 % in clinical reports. Approximately 300 cases of breast metastasis from extra mammary sites have been reported, mostly in small series or as a single case report. Gastrointestinal adenocarcinoma metastasising to the breast is also very rare and only 30 cases have been reported in the literature. Metastatic deposits within the breast may be difficult to distinguish from primary breast carcinoma. Radiological features and immunohistochemistry especially for steroid hormone receptors (ER/PR) and expression of gross cystic disease fluid protein (GCDFP) and presence of other immunohistochemistry protein factors in breast metastasis which are specific to primary site may be helpful in differentiating these two conditions. Materials and methods In this series of 3 cases of breast as an unusual site of metastasis, we present different cases of adenocarcinoma of stomach, sigmoid colon and kidney with metastasis to the breast and discuss the differential diagnosis and management plans. Conclusion In conclusion, secondary tumors to the breast are rare and thus differentiating primary tumors from metastatic breast carcinoma is important for rational and optimum therapy and avoidance of unnecessary radical surgery. Palpable breast lump without typical radiological signs of primary breast carcinoma in patients with known primary should be suspected of representing metastasis.
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Affiliation(s)
- Ashwin K Hebbar
- 39. "Krutika" 3rd Main, 2nd Cross Gururagavendra Nagar J.P. Nagar 7th Phase, Bangalore, Karnataka 560078 India ; Department of General Surgery, Shimoga Institute of Medical Sciences, Shimoga, Karnataka India
| | - K Shashidhar
- Department of ENT, Karnataka Institute of Medical Sciences, Hubli, Karnataka India
| | - Krishna Murthy S
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka India
| | - Veerendra Kumar
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka India
| | - Ravi Arjunan
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka India
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10
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Breast metastasis from esophagogastric junction cancer: a case report. Case Rep Surg 2014; 2014:489427. [PMID: 25013737 PMCID: PMC4074982 DOI: 10.1155/2014/489427] [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: 03/02/2014] [Revised: 05/24/2014] [Accepted: 05/29/2014] [Indexed: 11/24/2022] Open
Abstract
Metastasis to breast from nonmammary malignancy is only about 1.3–2.7%. A few cases of squamous cell carcinoma of esophagus and adenocarcinoma of stomach metastasizing to breast have been reported, but this is probably the first report of breast metastasis from esophagogastric junction (EGJ) cancer in the English literature. Herein we report a case of a 32-year-old patient diagnosed as adenocarcinoma of gastroesophageal junction, presenting with left breast metastasis two years after treatment. Given unusual site of metastasis in a follow-up case of EGJ cancer, not only it is challenging to differentiate it from primary carcinoma of breast but also it is important from treatment point of view. In our case, clinical data, radiology, histopathology, and immunohistochemistry (IHC) led us to reach the diagnosis.
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11
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Kim SJ. Magnetic resonance imaging features of inflammatory breast metastasis from gastric signet-ring cell carcinoma. Clin Imaging 2012; 37:569-73. [PMID: 23068056 DOI: 10.1016/j.clinimag.2012.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/04/2012] [Indexed: 11/17/2022]
Abstract
This report presents a rare case of inflammatory breast metastasis from gastric signet-ring cell carcinoma. The clinical and radiologic findings were similar to those of primary inflammatory carcinoma or acute mastitis. Further, ultrasonography showed diffuse skin thickening and a diffuse infiltrative hypoechoic lesion with marked posterior acoustic shadowing in the left breast. Similarly, magnetic resonance imaging showed diffuse skin thickening/enhancement and a diffuse non-mass-like enhancement in the left breast and to a lesser degree in the right breast.
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Affiliation(s)
- Suk Jung Kim
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, 1435 Jwa-dong, Haeundae-gu, Busan 612-030, South Korea.
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12
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Luk YS, Ka SYJ, Lo SSW, Chu CY, Ma MW. An unusual case of gastric cancer presenting with breast metastasis with pleomorphic microcalcifications. J Breast Cancer 2012; 15:356-8. [PMID: 23091550 PMCID: PMC3468791 DOI: 10.4048/jbc.2012.15.3.356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 07/03/2012] [Indexed: 11/30/2022] Open
Abstract
Breast metastasis from gastric carcinoma is rare. We present a case of right breast mass with microcalcification in which the diagnosis of poorly differentiated adenocarcinoma from the stomach was made after a biopsy. Pleomorphic microcalcification was noted in the ill-defined breast mass, which is a rare feature in breast metastasis. Since breast metastasis usually signifies advanced metastatic disease, differentiating primary breast cancer from metastasis is important for appropriate treatment.
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Affiliation(s)
- Yiu Shiobhon Luk
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China
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13
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Doval DC, Pande SB, Sharma JB, Khatri S, Khurana AK, Vaid AK, Chaturvedi AK, Hazarika D. Metastatic Signet-Ring Cell Gastric Carcinoma Masquerading as Breast Primary. Case Rep Gastroenterol 2009; 3:21-25. [PMID: 20651960 PMCID: PMC2895171 DOI: 10.1159/000203648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Metastasis to the breast from an extra-mammary primary is a rare phenomenon; metastasis from gastric carcinoma to the breast is extremely so. We report a case who initially presented as mucin-secreting and signet-ring cell tumor of the ovary, and after an interval of 8 months with breast and chest wall metastatic nodules. The covert gastric primary eluded the oncologists at both presentations.
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Affiliation(s)
- Dinesh Chandra Doval
- Departments of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India
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14
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Sato T, Muto I, Fushiki M, Hasegawa M, Hasegawa M, Sakai T, Sekiya M. Metastatic breast cancer from gastric and ovarian cancer, mimicking inflammatory breast cancer: report of two cases. Breast Cancer 2008; 15:315-20. [PMID: 18311479 DOI: 10.1007/s12282-008-0040-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 12/17/2007] [Indexed: 11/28/2022]
Abstract
Breast metastases from extra-mammary malignancies, especially those mimicking primary inflammatory breast carcinoma, are extremely rare. We report here two cases of inflammatory breast metastases from gastric or ovarian cancer. Both patients, who had prior advanced malignant disease, presented with unilateral breast redness and swelling with peau d'orange sign, resembling primary inflammatory breast cancer or acute mastitis. Breast biopsy revealed poorly differentiated adenocarcinoma with signet-ring cells or clear cell carcinoma in the lymphatic vessels and the parenchyma without an in situ lesion, similar to primary lesions of the stomach or ovary, respectively. Immunohistochemical staining for estrogen receptor, progesterone receptor, and gross cystic disease fluid protein 15 was of value for correct diagnosis. Since breast metastasis is a sign of poor prognosis of the primary malignant disease, the possibility of breast metastasis should be considered in appropriate patients to preclude unnecessary major surgery.
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Affiliation(s)
- Tomoi Sato
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu, Niigata 943-0192, Japan.
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15
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Krichen Makni S, Abbes K, Khanfir A, Frikha M, Sellami Boudawara T. [Metastatic signet ring cell carcinoma to the breast from stomach]. Cancer Radiother 2007; 11:276-9. [PMID: 17611138 DOI: 10.1016/j.canrad.2007.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Revised: 03/15/2007] [Accepted: 04/11/2007] [Indexed: 11/28/2022]
Abstract
Metastatic tumors in the breast are quite rare and constitute 0.5 to 6% of all breast malignancies. They often occur in a polymetastatic context. The most frequent primitive tumors are lymphoma, leukaemia and malignant melanoma. The gastric origin is seldom reported. We report here the observation of a 40-years woman operated in urgency for an acute abdominal syndrome. A gastric tumor was discovered intraoperatively with ovarian metastasis and peritoneal carcinosis. The pathological examination revealed a gastric signet ring cell carcinoma with an infiltration of the right ovary. Four months later, the patient presented with a lump of the right breast. The histologic examination corresponded to a mammary metastasis by a signet ring cell carcinoma from stomach. The objective of our work is to discuss through this observation the anatomoclinical and evolutionary characteristics of breast metastasis.
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Affiliation(s)
- S Krichen Makni
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
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Boutis AL, Andreadis C, Patakiouta F, Mouratidou D. Gastric signet-ring adenocarcinoma presenting with breast metastasis. World J Gastroenterol 2006; 12:2958-61. [PMID: 16718828 PMCID: PMC4087820 DOI: 10.3748/wjg.v12.i18.2958] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen (ER) and progesterone receptors (PR) and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a high-grade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases (Krukenberg’s tumor). A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.
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Affiliation(s)
- Anastasios L Boutis
- 3rd Department of Clinical Oncology, Theagenion Cancer Hospital, 54007, Thessaloniki, Greece.
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Varma GN, Winston JS, Hill HC, Gibbs JF, Proulx GM, McGrath BE, Javle MM. Unusual locations of involvement by malignancies: Case 3. Gastric signet ring carcinoma presenting as a diffuse thigh mass. J Clin Oncol 2003; 21:3371-3. [PMID: 12947076 DOI: 10.1200/jco.2003.09.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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