Multiple bone metastases in advanced breast cancer: a gastrointestinal surgical emergency

Abstract

Patient: Female, 33-year-old Final Diagnosis: Advanced breast cancer with bone metastasis Symptoms: Acute Abdominal pain Clinical Procedure: — Specialty: General Surgery • Oncology Objective: Unusual clinical course Background: Globally, acute abdominal pain is a common reason for admission to emergency departments. As with fever, it can be difficult to identify the cause. Metastatic breast cancer, which usually spreads to the lungs, brain, liver, and bones, is living longer among patients. Metastasis may present complications that were not previously seen due to improved survival rates. Patients with advanced metastatic breast cancer who experience sudden acute abdominal pain are at risk for this rare complication. Case Report: In an emergency department of gastrointestinal surgery, a 33-year-old female presented with sudden acute abdominal pain for no apparent reason. It was highly suspected that the patient had acute appendicitis based on his history and physical examination. CT scans of the chest and abdomen in the emergency department revealed bilateral breast cancer with multiple bone metastases (lumbar spine, iliac crest). Emergency abdominal exploration was performed after the patient's abdominal pain aggravated. In the patient's abdomen, extensive metastasis and cancerous adhesions were discovered, and the prognosis was extremely poor. It was not possible to explore the appendix and intestines further, so abdominal irrigation, abscess drainage, and abdomen closure were performed. Upon recovery from surgery, the patient was transferred to the Department of Breast and Thyroid Surgery for chemotherapy. A first course of doxorubicin liposome + cyclophosphamide chemotherapy was followed by a second course of albumin + paclitaxel chemotherapy. During the first course of treatment, a CT examination revealed new lumbar metastases and a reduction of the right breast mass. We are now in the process of further treatment and follow-up observation. Conclusions: A clinician should consider metastatic breast cancer pain when treating a female patient with acute abdominal pain. It is possible to die from acute abdominal pain, which has a wide range of causes. When breast cancer is not detected early, it can also occur repeatedly with various other clinical manifestations in the later stages.