Metastatic Breast Carcinoma Presenting as Perforated Appendicitis

Abstract

Background: Patients presenting with symptoms from unknown metastatic breast carcinoma are becoming increasingly uncommon. Perforated appendicitis from metastatic breast carcinoma is a rare entity with only a few published reports in the literature. Case Report: The case of a 76-year-old female patient who developed perforated appendicitis from previously unknown metastatic breast cancer is presented. During physical examination in the emergency department, a large left breast mass was palpated. The patient underwent an appendectomy and had no gross evidence of disease elsewhere in the intraperitoneal cavity. Subsequent pathologic examination of the appendix revealed a lobular carcinoma. Conclusions: The factors that influence the site of metastasis from breast cancer include estrogen receptor status and the subtype of carcinoma – ductal versus lobular.

Synchronous Orbital and Gastrointestinal Metastases from Breast Cancer: A Case Report and Review of Literature

“…Breast cancer metastasizing to the appendix is also a rare occurrence [ 23 ] and there are very few published reports of MBC presenting as appendicitis [ 29 – 31 ]. McLemore et al [ 13 ] reported that 21% of patients presented with metastatic disease masquerading as an alternate disease process, thus making accurate diagnosis difficult.…”

“…There were no histological features of appendicitis in the case described; however, the lumen of the appendix contained metastatic tumour deposits. Dirksen et al [ 31 ] have suggested that metastatic adenocarcinoma to the appendix can often present as appendicitis at a late stage leading to a high incidence of perforation. Chemotherapy and endocrine therapy, often in combination, is the treatment of choice in these patients.…”

Metastatic cholangiocarcinoma as a cause of appendicitis: a case report and literature review

“… 1 The primary sites of metastatic appendiceal carcinomas were the lung, breast, cervix, prostate, stomach, liver, nasopharynx, mediastinum, and pancreas. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 As far as we know, primary cholangiocellular carcinoma very rarely metastasizes to the appendix. 14…”

“…Without imaging studies for patients with suspected appendicitis, it is very difficult to diagnose primary or metastatic carcinoma of the appendix. 2 , 6 , 7 , 8 , 9 , 10 , 11 As imaging modalities are more frequently used, appendiceal masses are found before surgery more commonly, sometimes with unusual characteristics. 3 , 4 , 5 , 13 In a recent report of a case of appendiceal metastasis from a hepatocellular carcinoma, CT scan was useful in the diagnosis of the metastatic lesion.…”

Synchronous Colonic Adenocarcinoma and Metastatic Lobular Carcinoma in a Colectomy Specimen: A Rare Finding

“…Extrahepatic GI tract metastasis involves more often the stomach and the small intestine and, very rarely, the colon and rectum [ 6 ]. Other rare metastatic sites include the appendix [ 7 ], endometrium [ 8 ], gallbladder [ 9 ], kidney [ 10 ], orbit [ 11 ], pancreas [ 12 ], parotid gland [ 13 ], spleen [ 14 ], urinary bladder [ 15 ], uterine cervix [ 8 ], uterus [ 16 ], and vulva [ 17 ].…”