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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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Metastatic Breast Cancer Presenting as a Gastric Primary with Linitis Plastica: a Case Report and Review of Literature. J Gastrointest Cancer 2021; 51:698-702. [PMID: 32034640 DOI: 10.1007/s12029-020-00368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Teixeira S, Sousa C, Castro M, Preto AS, Cardoso A, Madureira A. Gastric metastases from invasive lobular carcinoma of the breast: Case report. Radiol Case Rep 2020; 16:372-376. [PMID: 33318776 PMCID: PMC7726484 DOI: 10.1016/j.radcr.2020.11.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 11/24/2022] Open
Abstract
Invasive lobular carcinoma is the second most common type of invasive carcinoma of the breast. Although rare, invasive lobular carcinoma can lead to gastric metastases, which may appear several years after the initial diagnosis. The diagnosis is difficult, either because of its rarity or because of overlapping symptoms and imaging findings with primary gastric carcinoma. Immunohistochemistry is the key to diagnosis. We report a case of a 40-year-old woman with a previous history of invasive lobular carcinoma of the breast 2 years before, who presented recurrent and nonspecific gastrointestinal symptoms. Imaging findings revealed linitis plastica and the biopsy showed the presence of signet ring cell neoplasia. After gastrectomy, immunohistochemistry demonstrated diffuse expression of GATA-3 and the presence of estrogen receptors in some neoplastic cells with CK20-, leading to the final diagnosis of gastric metastases from invasive lobular carcinoma of the breast.
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Affiliation(s)
- Sofia Teixeira
- Department of Radiology, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
- Corresponding author.
| | - Célia Sousa
- Department of Radiology, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Miguel Castro
- Department of Radiology, Centro Hospitalar e Universitário de São João, Porto, Portugal
- Breast Diagnostic Center, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Ana Sofia Preto
- Department of Radiology, Centro Hospitalar e Universitário de São João, Porto, Portugal
- Breast Diagnostic Center, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - António Cardoso
- Department of Radiology, Centro Hospitalar e Universitário de São João, Porto, Portugal
- Breast Diagnostic Center, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - António Madureira
- Department of Radiology, Centro Hospitalar e Universitário de São João, Porto, Portugal
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Geada L, Kantor M, Mohan K, Weingrad D, Nasiff LS. An Uncommon Presentation of a Common Disease: A Review of Gastric Metastasis From Breast Carcinoma. Cureus 2020; 12:e11920. [PMID: 33425505 PMCID: PMC7785476 DOI: 10.7759/cureus.11920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is the most common cancer in women, and the leading cause of cancer-related deaths worldwide. Despite advances in screening and treatment modalities, distant metastasis still develops. Breast cancer metastasis to the gastrointestinal tract is very rare, therefore, its diagnosis, therapeutic strategies, and prognosis pose a clinical problem for clinicians. We summarize the current knowledge regarding the clinicopathological characteristics and diagnostic strategies for metastatic tumors in the stomach of breast origin.
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Affiliation(s)
- Luis Geada
- Department of General Surgery, Aventura Hospital and Medical Center, Miami, USA.,Department of General Surgery, Kendall Regional Medical Center, Miami, USA
| | - Micaella Kantor
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
| | - Karthik Mohan
- Department of Gastroenterology, Palmetto General Hospital, Miami, USA
| | - Daniel Weingrad
- Department of Surgical Oncology, Aventura Hospital and Medical Center, Miami, USA
| | - Luis S Nasiff
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
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Chen P, Fang K, Su C, Chen P, Wang Y, Hou M, Lin H. Keep scalpel sheathed: A metastatic invasive ductal carcinoma mimics primary linitis plastica. ADVANCES IN DIGESTIVE MEDICINE 2019. [DOI: 10.1002/aid2.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Po‐Chun Chen
- Division of Gastroenterology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
| | - Kuan‐Chieh Fang
- Division of Gastroenterology, Department of MedicineTaipei Medical University Hospital Taipei Taiwan
| | - Chien‐Wei Su
- Division of Gastroenterology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Faculty of MedicineNational Yang‐Ming University Taipei Taiwan
| | - Ping‐Hsien Chen
- Endoscopy Center for Diagnosis and TreatmentTaipei Veterans General Hospital Taipei Taiwan
| | - Yen‐Po Wang
- Endoscopy Center for Diagnosis and TreatmentTaipei Veterans General Hospital Taipei Taiwan
| | - Ming‐Chih Hou
- Faculty of MedicineNational Yang‐Ming University Taipei Taiwan
- Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
| | - Han‐Chieh Lin
- Division of Gastroenterology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Faculty of MedicineNational Yang‐Ming University Taipei Taiwan
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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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Inoue M, Nakagomi H, Nakada H, Furuya K, Ikegame K, Watanabe H, Omata M, Oyama T. Specific sites of metastases in invasive lobular carcinoma: a retrospective cohort study of metastatic breast cancer. Breast Cancer 2017; 24:667-672. [PMID: 28108967 DOI: 10.1007/s12282-017-0753-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Invasive lobular carcinoma (ILC) is known to be the second most common histological type following invasive ductal carcinoma (IDC). Definitive clinical features of ILC are controversial. METHODS We retrospectively analyzed a cohort of 330 patients with metastatic breast cancer, 303 of IDC, 19 of ILC, and 8 of others. We compared the patient age and tumor-node-metastasis factors, disease-free survival (DFS), estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression at the primary site between ILC and IDC. We then selected the patients in the ER+ or PR+/HER2- subtype specifically and compared sites of recurrence, and the survival curve starting from the point of development of metastatic disease. RESULTS The clinical stage was significantly higher in the ILC patients than in the IDC (p = 0.001). The mean (±SD) of DFS for the ILC and IDC patients was 2.6 ± 0.6 and 2.4 ± 0.3 years, respectively, with no significant difference (p = 0.18). However, the hormone receptor status was same between both groups; the rate of HER2 positivity was significantly lower in the ILC group (0%) than in the IDC group (16.2%) (p = 0.05). In ER+ or PR+/HER2- subtype, the mean DFS for the ILC and IDC was 2.9 ± 0.6 and 3.1 ± 0.3 years, and the median survival time after the recurrence for ILC and IDC patients was 4.2 ± 0.7 and 5.6 ± 0.7 years, respectively, with no significant difference (p = 0.77). The frequency of lung metastases was significantly lower in the ILC group (6.3%) than in the IDC group (53.7%) (p < 0.01), while the frequency of peritoneal metastases was significantly higher in the ILC group (68.8%) than in the IDC group (1%) (p = 0.00). Of note, the prognosis after the diagnosis of peritoneal metastases was poor, with a median survival time of 19 ± 9 months and resistance to hormone therapy. CONCLUSIONS The extremely high rate (68.8%) of peritoneal metastases was observed in long-term follow-up for the metastatic breast cancer patients with ILC. We need to reveal the definitive feature of ILC and develop new therapeutic strategies to prevent the dissemination of ILCs.
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Affiliation(s)
- Masayuki Inoue
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan.
| | - Hiroshi Nakagomi
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan
| | - Haruka Nakada
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan
| | - Kazushige Furuya
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan
| | - Kou Ikegame
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan
| | - Hideki Watanabe
- Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan
| | - Masao Omata
- Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Kofu, Japan.,University of Tokyo, Tokyo, Japan
| | - Toshio Oyama
- Department of Pathology, Yamanashi Prefectural Central Hospital, Kofu, Japan
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Zullo A, Balsamo G, Lorenzetti R, Romiti A, De Francesco V, Hassan C, Manta R. Gastric metastases from gynaecologic tumors: case reports and review of the literature. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:483. [PMID: 28149845 DOI: 10.21037/atm.2016.12.51] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The stomach is an infrequent localization of tumor metastases, and metastases originating from primary gynaecological cancers are particularly rare. We described the case of three females with ovarian, uterine, and breast metastases in the stomach, and we performed a systematic review of the literature of cases diagnosed at endoscopy. Overall, data of 18 patients with gastric metastases originating from the ovary, 11 from the uterus, and 159 from breast cancer were analyzed. Therefore, gastric metastasis mainly occurs from breast cancer, whilst both ovarian and uterine metastases are distinctly less frequent, but not impossible.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | | | | | - Adriana Romiti
- Oncology Unit, Sant'Andrea University Hospital, Rome, Italy
| | | | - Cesare Hassan
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Raffaele Manta
- Gastroenterology Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy
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Ricciuti B, Leonardi GC, Ravaioli N, De Giglio A, Brambilla M, Prosperi E, Ribacchi F, Meacci M, Crinò L, Maiettini D, Chiari R, Metro G. Ductal Breast Carcinoma Metastatic to the Stomach Resembling Primary Linitis Plastica in a Male Patient. J Breast Cancer 2016; 19:324-329. [PMID: 27721883 PMCID: PMC5053318 DOI: 10.4048/jbc.2016.19.3.324] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/25/2016] [Indexed: 02/07/2023] Open
Abstract
Breast cancer metastases to the gastrointestinal tract are very rare occurrences. Among the histological subtypes of breast cancer, invasive lobular carcinomas have a high capacity of metastasis to uncommon sites including the stomach. Conversely, there has not been sufficient evidence supporting the gastric metastasis of invasive ductal carcinoma. Herein, we report a unique case of metastatic ductal breast carcinoma mimicking primary linitis plastica in a male patient, particularly focusing on the clinical and pathological features of presentation. Moreover, we propose a immunohistochemical panel of selected antibodies including those for cytokeratin 20, cytokeratin 7, estrogen receptor, progesterone receptor, E-cadherin, gross cystic disease fluid protein 15, and GATA binding protein 3 for an accurate differential diagnosis.
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Affiliation(s)
- Biagio Ricciuti
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Noemi Ravaioli
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Andrea De Giglio
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Marta Brambilla
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Enrico Prosperi
- Department of Experimental Medicine and Biochemical Sciences, Section of Anatomic Pathology and Histology, University of Perugia, Perugia, Italy
| | - Franca Ribacchi
- Department of Diagnostic Cytology and Histology Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Marialuisa Meacci
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Lucio Crinò
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Daniele Maiettini
- Department of Diagnostic Imaging, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Rita Chiari
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giulio Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
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