Rare common bile duct metastasis of breast cancer: A case report and literature review

Abstract

BACKGROUND Breast cancer is the most common tumor in women, and about one-third of cases develop metastatic disease. However, metastatic breast cancer rarely invades the common bile duct (CBD) directly without involving the liver, and involvement of the gastrointestinal tract is rare. Cases of such metastases pose a particular diagnostic challenge. CASE SUMMARY A 55-year-old female presented to the Department of Gastroenterology with complaint of a 2 mo history of right upper abdominal pain accompanied by pain in the right back, aggravated after eating greasy diet. The patient had received a diagnosis of breast cancer 3 years prior. Physical examination showed obvious superficial protuberant erythema on the left neck and chest skin, with slight tenderness and burning sensation. Endoscopic retrograde cholangiopancre-atography showed an obstruction at the end of the CBD. Histopathology of the CBD and symptomatic skin biopsies showed positivity for cytokeratin 7 and trans-acting T-cell-specific transcription factor breast cancer biomarkers. A cancer embolus was also found in the skin vasculature. Accordingly, the diagnosis of breast cancer metastases to the skin and biliary ducts was made. A plastic biliary sent was placed, which relieved the right upper abdominal pain and protected against unnecessary hepatectomy surgery. CONCLUSION Although rare, biliary metastasis should be considered in patients with bile duct stenosis and a history of breast cancer.

A case of obstructive jaundice caused by metastasis of breast cancer to the intra/extrahepatic bile duct

“…7 Moreover, Tang et al reported that endoscopic ultrasound for metastatic bile duct tumor revealed a widening of the bile duct wall. 8 Unfortunately, endoscopic ultrasound/intraductal ultrasound was not performed in this case, but endoscopic ultrasound/intraductal ultrasound often produces findings similar to those for gastrointestinal subepithelial tumors, which might provide a modality to facilitate diagnosis. Furthermore, secondary sclerosing cholangitis should be regarded as a possible differential diagnosis for such findings.…”

Endoscopic drainage with a metallic stent for obstructive jaundice caused by bile duct metastasis of breast Cancer: A case report

“…These case reports were obtained through a search of PubMed for articles published from 1946 to 2021, using the search terms "breast cancer" and "biliary metastasis". In addition to these, Japanese case reports were obtained through a search of the Japana Centra Revuo Medicina Web for articles published from 1977 to 2021, using the Japanese equivalents of the search terms mentioned above [2][3][4][5][6][7][8][9][10][11][12][13] . The details of these case reports are presented in Table 1.…”

Endoscopic drainage with a metallic stent for obstructive jaundice caused by bile duct metastasis of breast cancer: A case report

“…In addition to these, Japanese case reports were obtained through a search of the Japana Centra Revuo Medicina Web for articles published from 1977 to 2021, using the Japanese equivalents of the search terms mentioned above. 1,[3][4][5][6][7][8][9][10][11][12][13][14] The details of these case reports are presented in Table 1. The average age of the patients was 56 years (42-70 years).…”

“…Regarding treatment for objective jaundice by bile duct stenosis, only five cases were treated by endoscopic drainage (Table 2). 1,3,4,6 To patients who might respond to other modes of therapy enabling longer survival, surgical bypass could be more effective than endoscopic treatment. 12 But in our case, endoscopic drainage was chosen because metastases were found in multiple organs other than the bile ducts, so long-term prognosis was not promising, and also because of the invasiveness of surgery.…”

“…These case reports were obtained through a search of PubMed for articles published from 1946 to 2021, using the search terms “breast cancer” and “biliary metastasis.” In addition to these, Japanese case reports were obtained through a search of the Japana Centra Revuo Medicina Web for articles published from 1977 to 2021, using the Japanese equivalents of the search terms mentioned above. 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 The details of these case reports are presented in Table 1 . The average age of the patients was 56 years (42–70 years).…”