Rectal metastasis from lobular breast carcinoma 15 years after primary diagnosis

Abstract

Lobular breast carcinoma represents 2-20% of infiltrative carcinomas of the breast. The incidence of extrahepatic gastrointestinal (GI) tract metastases observed in necropsy studies varies from 6% to 18% and the most commonly affected organ is the stomach, followed by colon and rectum [1-4]. Reported herein is the case of a 67-year-old woman who was primarily diagnosed and surgically treated for a lobular carcinoma of the breast 15 years ago and is now referred with back pain and right hydronephrosis caused by a metastasis in rectum. Frequently, the absence of specific symptoms of digestive metastases of breast cancer leads to a misdiagnosis of this pathology [5-7]. The treatment will be based on a detailed clinical history and histopathological findings. Metastases from breast cancer in GI tract tumours must be excluded in a patient with previous history of breast carcinoma, as in the case reported herein.

Lobular Breast Cancer Metastasis to the Colon, the Appendix and the Gallbladder

“…For our patient, these symptoms appeared 5 years following the surgical treatment of the primary tumor, and she had been asymptomatic at the follow-up revisions, lacking any clinical history suggestive of either constitutional symptoms or potential gastrointestinal tumor pathology. In the majority of case reports dealing with colorectal metastasis of breast cancer, the average interval between the manifestation of the primary tumor and the appearance of metastatic symptoms was 6-8 years [8]. …”

“…Surgical treatment of the gastrointestinal metastasis of breast cancer does not seem to increase the survival rates, except in a subgroup of patients who exclusively suffer from this form of metastasis [9]. However, cases with an up to 9-year survival period have been described in the literature; this fact emphasizes the importance of a timely diagnosis and a prompt initiation of therapy [8]. It is therefore crucial to avoid potential misdiagnosis; in the case series conducted by McLemore et al [10], which included 73 patients, 21% of the cases were initially misdiag-nosed and 11% had a correct diagnosis only after the use of exploratory laparotomy.…”

Case report and literature review: Metastatic lobular carcinoma of the breast an unusual presentation

“…Remissions are observed in 32-53% of patients. 18 Survival after diagnosis of GI metastases from a breast primary is poor with few patients surviving beyond two years, although survival up to nine years has been reported. 19,20 …”

Rectal metastasis from breast cancer: an interval of 17 years

“…The most frequent sites of the GI tract involved are the stomach and the small intestine, while colonic and rectal metastases are extremely rare 1. Lobular carcinoma represents 2–20% of infiltrative carcinomas of the breast 3. GI system, gynaecologic organ and peritoneum-retroperitoneum metastases are more prevalent in lobular carcinoma 4.…”