A Very Rare Reason for Gastric Perforation, Caused by Gastric Metastasis of Breast Cancer: Case Presentation

Güler, Sertaç Ata; Şimşek, Turgay; Pösteki, Gökhan; Güreşin, Alican; Çınar, Saffet Meral; ONBAŞILAR>, Umut; Cantürk, Nuh Zafer

doi:10.5152/ejbh.2018.4285

Cited by 11 publications

(9 citation statements)

References 13 publications

(15 reference statements)

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“…There are also some unusual presentations, such as gastric outlet obstruction and gastric perforation, which are pathologically confirmed as gastric metastasis from breast cancer. 10,11…”

Section: Discussionmentioning

confidence: 99%

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Gastric metastasis from breast cancer: five cases and a single-institutional review

Cheng,

Jia,

Zhang

et al. 2024

J Int Med Res

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Gastric metastasis from breast cancer has a high rate of misdiagnosis and missed diagnosis. Data of patients who had gastric metastasis from breast cancer were retrieved from our hospital between 2014 and 2020. The gastric metastasis from breast cancer incidence was 0.04% (5/14,169 cases of breast cancer). Four patients had invasive lobular carcinoma, and the other patient had invasive ductal carcinoma. The time from the initial diagnosis of breast cancer to the appearance of gastric metastasis ranged from 0 to 12 years. One patient’s endoscopic presentation was similar to mucosal-associated lymphoid tissue lymphoma and presented with gastric mucosal congestion and edema, widened wrinkles, mixed color fading, and redness. The initial pathological diagnosis of this patient was mucosal-associated lymphoid tissue lymphoma, and breast cancer was finally confirmed by immunohistochemistry. Hormonal receptors were highly expressed in four patients with primary and metastasis lesions and were negative in one patient. Human epidermal growth factor receptor 2 was negative in all patients. Mammaglobin and GATA3 were positive in all patients. In conclusion, the gastric metastasis of breast cancer incidence rate is low, and misdiagnosis can lead to insufficient or excessive treatment. Multiple biopsies and immunohistochemistry should be performed to diagnose gastric metastasis of breast cancer.

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“…There are also some unusual presentations, such as gastric outlet obstruction and gastric perforation, which are pathologically confirmed as gastric metastasis from breast cancer. 10,11…”

Section: Discussionmentioning

confidence: 99%

“…There are also some unusual manifestations, such as gastric outlet obstruction and gastric perforation, in these patients. [7][8][9][10][11] In addition, doctors' lack of knowledge of gastric metastasis has led to a decrease in the accuracy of diagnosis of this type of metastasis.…”

Section: Introductionmentioning

confidence: 99%

Gastric metastasis from breast cancer: five cases and a single-institutional review

Cheng,

Jia,

Zhang

et al. 2024

J Int Med Res

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“…Yoshitomi and Tsuji [ 13 ] have reported a patient with adrenal metastasis from breast cancer who underwent adrenalectomy and toremifene endocrine therapy and was followed by 28 months of recurrence-free survival. LA has been used in patients with solitary adrenal metastasis, but this procedure is limited by the tumor size [ 14 ]. Usually, surgical excision is recommended in the following situations: solitary metastatic lesion and can be removed or well controlled; there are no metastasis in other organs; and the patient is generally in good condition and can tolerate surgery.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Gland Metastasis of Breast Invasive Mucinous Carcinoma: A Rare Case Report and Review of Literature

Sun

Wang²,

Zhang

et al. 2022

Case Rep Oncol

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The adrenal gland is a frequent site for metastasis, and the majority of the metastatic lesions of the adrenal gland normally originate from lung cancer, colon cancer, renal cell carcinoma, and melanoma. However, adrenal gland metastasis from breast invasive mucinous carcinoma is extremely rare. This report described a rare case of right adrenal gland metastasis in a 48-year-old female, who was diagnosed with breast invasive mucinous carcinoma and underwent right modified radical mastectomy with axillary lymph node dissection 5 years previously. A mass located on the right adrenal gland was detected during a routine examination 2 months ago. The patient was asymptomatic and adrenal gland MRI revealed a mass in the right adrenal gland. Definitive preoperative diagnosis failed to be established. Right adrenal gland laparoscopic adrenalectomy was performed and the diagnosis of adrenal gland metastasis of breast carcinoma was confirmed by pathological and immunohistochemical examination, especially ER, PR, GATA3, and HER-2. The patient remained in good condition by the time of writing.

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“…However, with recent increased treatment options, survival of patients with MBC is expected to be prolonged. Meanwhile, the treatment effects sometimes differ among metastatic organs, and risk of lethal conditions, such as GI bleeding and perforation, should be considered in cases where GI lesions progress [ 7 ]. From this perspective, we believe that follow-up GI endoscopy should be considered after the diagnosis of GI metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with GI metastasis usually complain of some clinical symptoms, such as upper abdominal discomfort and pain. However, metastatic lesions may also be found incidentally by endoscopy for screening without any clinical symptoms [ 3 , 5 , 6 , 7 ]. The most common endoscopic finding of gastric metastases from breast cancer is a submucosal tumor-like appearance, but there are a variety of reports describing benign tumor-like findings, such as raised erosions, type 4 gastric cancer-like appearance, and even hyperplastic polyp-like appearance [ 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

A Gastric Metastatic Lesion That Resembled Early-Stage Gastric Cancer on Endoscopy during Treatment for Recurrent Breast Cancer: A Case Report

et al. 2021

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Breast cancer metastasis to the gastrointestinal tract is relatively rare. Patients with such disease often develop gastrointestinal symptoms, but it is sometimes asymptomatic. Endoscopic findings of gastric metastasis from breast cancer markedly vary from benign to malignant, and even in suspected malignant cases, it is often difficult to differentiate between primary and metastatic disease. We experienced a case in which an endoscopic examination performed during the treatment for metastatic breast cancer resembled an early-stage gastric cancer. A 71-year-old woman underwent curative surgery for right breast cancer 16 years previously. She underwent endoscopic submucosal dissection for early-stage gastric cancer 5 years ago. Two years ago, she developed metastatic disease in the lungs and mediastinal lymph nodes, and endocrine therapy was administered. At the same time, a follow-up endoscopy revealed a new elevated lesion, suspected to be an early-stage gastric cancer. However, histological diagnosis of the biopsy was metastasis of breast cancer. One and a half years later, a follow-up endoscopy revealed a gastric lesion that had reduced in size. She is still alive, having received a variety of systemic treatments. Patients with metastatic breast cancer are experiencing prolonged survival. Thus, follow-up endoscopy should be considered after the diagnosis of gastrointestinal metastasis considering the risk of lethal conditions, such as gastrointestinal bleeding and perforation. Our case serves as a reminder to clinicians how difficult it is to determine whether a gastric lesion is primary or metastatic based on endoscopic findings and the importance of communication with endoscopists and pathologists.

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A Very Rare Reason for Gastric Perforation, Caused by Gastric Metastasis of Breast Cancer: Case Presentation

Cited by 11 publications

References 13 publications

Gastric metastasis from breast cancer: five cases and a single-institutional review

Gastric metastasis from breast cancer: five cases and a single-institutional review

Adrenal Gland Metastasis of Breast Invasive Mucinous Carcinoma: A Rare Case Report and Review of Literature

A Gastric Metastatic Lesion That Resembled Early-Stage Gastric Cancer on Endoscopy during Treatment for Recurrent Breast Cancer: A Case Report

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