A case of recurrent invasive lobular carcinoma of the breast found as metastasis to the duodenum

Abstract

A 57-year-old woman underwent modified radical mastectomy for cancer of the left breast (stage IIB) in February 2004. Invasive lobular carcinoma was diagnosed on histopathological examination. The patient received postoperative chemotherapy and endocrine therapy on an outpatient basis and was observed. In August 2005, anorexia developed. Blood chemical tests showed elevated levels of liver enzymes and bilirubin. Computed tomography (CT) of the abdomen revealed an enlarged duodenum and dilated intrahepatic biliary and pancreatic ducts. Upper gastrointestinal endoscopy showed edema of the duodenum. A biopsy yielded a diagnosis of poorly differentiated adenocarcinoma. Duodenal carcinoma was suspected, and a pancreatoduodenectomy was performed. Duodenal metastasis from invasive lobular carcinoma was diagnosed on postoperative histopathological examination. After surgery, the patient recovered uneventfully and was discharged from the hospital. In March 2006, bilateral hydronephrosis apparently caused by peritoneal metastasis developed, and she subsequently died. Invasive lobular carcinoma is characterized by the development of gastrointestinal metastases and is rarely detected before autopsy. We describe our experience with a patient in whom invasive lobular carcinoma of the breast with metastasis to the duodenal wall was definitively diagnosed on laparotomy.

Duodenal metastasis from recurrent invasive lobular carcinoma of breast: a case report and literature review

“…To the best of our knowledge and based on a careful review of the literature, we conclude that our patient is the first case of a duodenal metastasis from breast carcinoma in China. In other countries, similar cases have been reported only sporadically [6][7][8].…”

“…Immunohistochemistry staining of the cells was strongly positive for CK7, gross cystic disease fluid protein (GCDFP) 15, mammaglobin, ER, and progesterone receptor (PR) and negative for cytokeratins 20 (CK20) and E-cadherin, which is consistent with a diagnosis of metastatic breast cancer (Figs. 5,6,7,8). Percutaneous transhepatic choledochal drainage (PTCD) was performed immediately to drain bilirubin.…”

Hydronephrosis Caused by Metastatic Breast Cancer

“…A PubMed search for the keywords "breast cancer" and "hydronephrosis" identified 10 cases of postoperative recurrence, as shown in Table 2 [3][4][5][6][7][8][9][10][11][12]. The median time from surgery to diagnosis of hydronephrosis was 76.5 months (18-360 months), and the histological type was IDC in 4 cases, ILC in 5 cases, and unknown in 1 case.…”

Obstructive Colon Metastases from Lobular Breast Cancer: Report of a Case and Review of the Literature

“…The terminal ileum is more often involved that the rest of the small bowel 18,19 . Metastasis to the duodenum 20,21 and the appendix 22 has sometimes been reported.…”