Breast Metastasis From Rectal Signet-Ring Cell Carcinoma: A Case Report and Review of Literature

Abstract

BackgroundMetastatic rectal cancer (mRC) of the breast is an extremely rare clinical situation. There are few reported cases in domestic or foreign literature. The clinicopathologic characteristics along with the diagnostic and therapeutic strategies of such cases remain relatively unclear. Here, we would like to provide our comprehensive insights into this rare entity.MethodsWe present a case that till now is the first reported breast metastasis from rectal cancer pathologically diagnosed as a signet-ring cell carcinoma, and we review the current literature on this rare event. The detailed clinical data, histopathology, management, and follow-up aspects were gathered for analysis.ResultsA total of 15 cases were collected including the current case. Breast metastases from rectal cancer present at an average age of 47.7 years (range, 28 to 69 years) and appear with an average interval of 28.4 months (range, 5 months to 18 years) following primary tumor diagnoses. Of the 15 cases, 8 and 5 are pathologically diagnosed as adenocarcinomas and mucinous adenocarcinomas, respectively. Most cases (11/15) are accompanied by extramammary metastases. About half of the breast metastases (7/15) were to the left. In all cases, the main complaints were palpable mass. The average maximum diameter of the metastatic mass is 2.7 cm (range, 1–11 cm). The majority (8/12) of cases with accessible therapy information exclude the option of local surgery.ConclusionPrevious cancer history and accurate immunohistochemistry data play critical roles to distinguish mammary metastasis from a primary neoplasm of the breast. Mastectomy and molecular-targeted drugs should be considered with priority if systemic condition supports them.

Case Report: Systemic treatment for breast and vulvar metastases from resected rectal signet ring cell carcinoma

“…Compared to the liver or lung metastases, rectal cancer breast metastasis (RCBM), let alone vulvar metastasis, is rather uncommon in existing literature (17)(18)(19). Except 2 male patients, RCBM mainly involved the female in previous reports (20,21).…”

“…RCBM presents at a younger age 47.7 years (17) than primary rectal cancer (63 years) (5). The mean interval between the initial diagnosis of rectal cancer and the occurrence of breast metastasis was reported to be 28.4 months (range, 5 months to 18 years) (17). Williams et al (25) suggested that breast metastasis usually served as a part of systemic metastases and was associated with poor expected survival, with a median survival of 10 months post diagnosis.…”

Lung cancer with breast metastasis: a case report and review of the literature

“… 4 Currently, only a small number of reports have described metastasis of malignant tumors, such as melanoma, lymphoma, and rectal cancer, to the breast. 7 Patients with breast metastasis usually have widespread disease and a poor prognosis. 4 Breast lump(s), pain, and nipple discharge are typical symptoms of primary breast cancer.…”

Bilateral Breast and Ovarian Metastases of Signet-ring Cell Gastric Cancer: A Case Report and Literature Review

“…Extramammary breast metastases are more common in patients with hematological and cutaneous melanoma [4]. However, the lung, ovary, cervix, prostate, kidney, gastrointestinal system, liver, and head and neck regions are other possible initial tumor sites [1,2,[4][5][6][7]. There were 73 cases of gastric cancer with breast metastasis published online up until June 2022, including 17 cases with breast and ovarian metastases and only 6 cases with bilateral breast and ovarian metastasis (Table 1).…”