A Case of Esophageal Stricture Due to Metastatic Breast Cancer Diagnosed by Endoscopic Mucosal Resection

Abstract

Metastasis of breast cancer to the esophagus has been reported but is rare. It is often difficult to diagnose metastases of breast cancer to the esophagus because they are often located in the submucosa and covered with normal mucosa. Although several methods have been reported in order to obtain specimens for pathological diagnosis, the adverse effects including bleeding and perforation were considerable problems. We report a case of a patient with esophageal stricture due to metastatic breast cancer to the esophagus. Pathological diagnosis was successfully obtained using endoscopic mucosal resection of the esophagus.

Esophageal perforation due to breast cancer metastasis: Case report

“…Asch et al also reported an autopsy series of 337 patients with diagnosis of breast cancer and only 20 cases of esophageal metastases, of which none had specific gastrointestinal symptoms on their previous medical history. [5] On this group of patients, dysphagia is the most common symptom and has been reported to appear within eight years of the primary diagnosis of breast carcinoma, [5] as presented on the patient exposed in this case report. There are many practices accepted regarding treatment for these patients.…”

“…There are many practices accepted regarding treatment for these patients. Studies had reported that endoscopic resection technique is a suitable option with adequate results and is considered a safe method, [5] however, is difficult to identify this pathology before it manifests with a complication like stenosis or perforation. In the scenario of complication, like the case presented in this paper, the minimally invasive approach with laparoscopic surgery provides a good option for a better postoperative recovery and a prompt referral to an Oncology service to continue treatment providing a better chance to a good survival in these patients.…”

“…[4] The diagnosis of breast cancer metastases to the esophagus is difficult because there are no specific symptoms and many cases are found during autopsy or on the postoperative pathology report, there are only a few cases diagnosed with biopsy during endoscopic revision because an adequate specimen is difficult to acquire, The importance of identifying them relies on the fact that the only effective treatment is resection, either endoscopic or surgical. [5] This paper presents the case of a patient with stenosis of the esophagus due to breast cancer metastasis identify due to complication with perforation and managed with minimally invasive surgery.…”

Esophageal metastasis of breast carcinoma

“…Among 23 cases, in 11 cases, including our case [8, 13-17, 19, 20], the esophagus was the first recurrent site, and in 7 cases [7,[9][10][11][12][13], it was not the first site of recurrence. In the other five cases [1,18], this detail is not mentioned. A long interval between primary treatment for the breast tumor and its recurrence with esophageal involvement has been reported.…”

“…From the standpoint of metastatic esophageal tumors, the most common malignancy to metastasize to the esophagus is breast carcinoma [3,6,7]. To the best of our knowledge, there have been 23 cases (16 case reports) including our case of esophageal metastasis from breast cancer in the English-language medical literature for the last 20 years [1,[7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Among 23 cases, in 11 cases, including our case [8, 13-17, 19, 20], the esophagus was the first recurrent site, and in 7 cases [7,[9][10][11][12][13], it was not the first site of recurrence.…”