Metastases of lobular breast carcinoma in the terminal ileum and ileocaecal valve

Abstract

Gastrointestinal (GI) metastases from primary breast carcinoma are rare but more common in invasive lobular carcinoma than invasive ductal carcinoma. The symptoms may be non-specific and the presentation can occur many years after the initial primary breast carcinoma. Radiological and endoscopic findings can be difficult to distinguish from inflammatory bowel disease and primary carcinoma of the GI tract. Histological and immunohistopathology assessment will usually confirm the diagnosis of metastatic breast carcinoma. We report the first case of lobular breast carcinoma metastasizing to the terminal ileum and ileocaecal valve 19 years following treatment for breast cancer in an 82-year-old woman. Staging investigations revealed synchronous metastases in bones and the pleura. A high index of suspicion and awareness of the potential long interval in the presentation of metastatic breast cancer help in making an accurate diagnosis and rapid clinical management.

Rectal metastasis from Breast cancer: A rare entity

“…Breast cancer is the second most common cancer to metastasise to the GI tract, second only to malignant melanoma [2,3] . ILC accounts for 10–20% of breast tumours and is the most likely breast cancer to metastasise due to its loss of cell–cell adhesion molecules [4] .…”

“…The risk of local or distant metastasis is 60% at the time of first presentation and 30–80% will develop distant metastases after completing the treatment for cancer [5,6] . Although the usual sites for any breast cancer metastases are liver, bone, lungs, brain and nodes [1,2] , secondary deposits to the GI tract have been previously documented, but are certainly a rare entity. Borst and Ingold, in their study of 2604 cases of breast cancer had reported GI metastases in only 17 cases (0.7%) [7,8] .…”

“…The sites of metastases can be anywhere from the oropharynx [4,11] to the anus [4,12,13] . The most common site is stomach [14,15] followed by small bowel, with colorectal metastasis being much rarer [2,4,5,16] . The most typical presentation is the thickening and rigidity of the rectal wall, as seen in our case, rather than identifying a localized mass [14] .…”

“…The risk of distant metastases from breast cancer is around 50%, most commonly to nodes, lung, bones, brain and liver [1,2] . There have been several reports of metastasis to GI tract although this is rare and accounts for less than 1% of all metastatic cases.…”

Inusual metástasis a colon de primario de mama

“…La biopsia debe ser profunda, ya que las metástasis, a diferencia de los tumores primarios, comienzan por afectar la serosa y la submucosa. Una mucosa intacta con serosa invadida por células tumorales histológicamente idénticas a las del tumor primario de mama confirma el diagnóstico de metástasis 9 . De igual forma, si hay receptores hormonales tanto en el cáncer de mama primario como en la tumoración de colon, se confirma el origen metastásico de esta última.…”