Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach

Ulmer, Laura L.; Cormier, Ian; Jha, Lokesh K.; Singh, Shailender; Fisher, Kurt W.; Hewlett, Alexander

doi:10.1155/2018/2820352

Cited by 8 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ulmer et al described a similar case to ours where previous gastric mucosal biopsies had been negative; however, a EUS-guided fine needle aspiration clinched the final diagnosis of metastatic lobular breast carcinoma causing gastric outlet obstruction [6]. Of note, the EUS-guided biopsy in our case was a mucosal biopsy and not a fine needle aspiration (FNA) biopsy.…”

Section: Discussionsupporting

confidence: 48%

Unusual Presentation of Gastric Outlet Obstruction Due to Breast Cancer Metastasis: A Case Report

Mohy-ud-din

Patek

Dhawan

2019

Cureus

View full text Add to dashboard Cite

Gastric outlet obstruction can be caused by various pathologies, including peptic ulcer disease, gastric polyps, and malignancies. The incidence rate of breast cancer metastasis to the stomach is only 0.3%. We describe a rare case of an 83-year-old female with a remote history of breast cancer who presented with symptoms of nausea and vomiting. She underwent an upper endoscopy, and biopsies revealed chronic gastritis. However, when she presented for the second time with similar symptoms, she underwent endoscopic ultrasound (EUS)-guided biopsies, which clinched the diagnosis of breast cancer metastasis causing gastric outlet obstruction. This case describes the importance of keeping a wide differential diagnosis for the causes of gastric outlet obstruction and the significance of deeper EUS-guided biopsies if initial endoscopic biopsies are inconclusive.

show abstract

Section: Discussionsupporting

confidence: 48%

Unusual Presentation of Gastric Outlet Obstruction Due to Breast Cancer Metastasis: A Case Report

Mohy-ud-din

Patek

Dhawan

2019

Cureus

View full text Add to dashboard Cite

show abstract

“…Thus, it is suggested to perform deep and extensive biopsies and to repeat them if negative, for obtaining representative material (41,42).…”

Section: Pathologic Diagnosticmentioning

confidence: 99%

Gastric Metastasis of Invasive Lobular Breast Carcinoma, a Current Diagnostic and Treatment Challenge - A Review

Bîrlă¹,

Dinu²,

Iosif³

et al. 2019

chr

View full text Add to dashboard Cite

patologic corect, imunohistochimia ne oferă un diagnostic de certitudine. Introducerea unui protocol de supraveghere endoscopică pentru pacienţii cu cancer lobular de sân ar putea fi o propunere pentru detectarea precoce a metastazelor gastrice care să permită o terapie adecvată.Cuvinte cheie: metastaze gastrice, cancer de sân lobular, teste imunohistochimice, endoscopie superioară Abstract Introduction: The predilection of lobular invasive breast cancer metastasis for the stomach is a topic that has succumbed to various assumptions over the time. Background and Aims: Gastric metastasis of lobular breast cancer is unusual and it can be diagnosed after a long period of time from primary tumor diagnosis. The aim of this study was to review current knowledge regarding the current methods of diagnosis and treatment of gastric metastasis of breast cancer. Methods: A systematic literature search was performed in the Pub-Med -Medline database using the terms "gastric metastasis of lobular breast cancer" and "gastric metastasis features" to identify articles relevant to gastric metastasis of lobular breast cancer. Results: Several papers have shown that the topic is rarely presented in the form of case presentations or miniseries by summing up sporadic cases. Due to its rarity and metastasis specificity as host type and appearance after latency of lobular breast cancer makes its gastric metastasis considered atypical and occasionally confused with a primary stomach malignancy. The most recent articles present the immunohistochemical diagnostic criteria of this clinical entity and a new therapeutic approach. Conclusion: At patients with gastric metastasis of lobular breast cancer, obtaining pathologic material and biopsies interpretation can be a real challenge for getting a correct pathologic diagnosis, immunohistochemistry gives us definite diagnosis. The introduction of an endoscopic surveillance protocol for patients with lobular breast cancer could be a proposal for the detection of early gastric metastases allowing for appropriate therapy.

show abstract

“…In one case report [18] first histological examination of gastric biopsies was negative; after synchronous diagnosis of primary breast cancer, endoscopy was repeated and biopsies of submucosal layer were performed again, showing gastric metastasis from lobular cancer. Also in another patient [19] initial gastric biopsies were negative, reporting only mild chronic gastritis. Endoscopic ultrasound showed thickening of the muscolaris propria so biopsies were repeated focusing on this layer: muscular wall was infiltrated by malignant cell from lobular breast carcinoma.…”

Section: Diagnosis (Instrumental)mentioning

confidence: 97%

“…Surgical treatment alone was chosen in 7 [26,27,42] patients, with three [27,42] of them in an emergency setting for bleeding and perforation. Endoscopic stenting for obstruction was used successfully in 2 patients [19,22] .…”

Section: Therapymentioning

confidence: 99%

See 1 more Smart Citation

Breast cancer metastasis to the stomach

D’Angelo¹,

Rampini²,

Cardella³

et al. 2019

JCMT

View full text Add to dashboard Cite

Aim: This study focuses on the stomach as an unusual but not rare site of metastasis of breast cancer. Methods: We performed a literature search on gastric metastasis from breast cancer searching for reviews from 2000 to 2018 and case reports from 2013 to 2018. We found 11 reviews and 36 case reports and we compared their findings about important aspects of gastric metastasis, such as disease free survival, overall survival, symptoms, endoscopic findings, therapy, histology, and immunohistochemistry. Results: The incidence of stomach as site of metastasis of breast cancer ranges from 5% to 18%. Reviews and case reports reached similar conclusions about several of the aforementioned aspects: invasive lobular breast cancer (ILC) is mainly responsible for gastric metastases; disease free survival can vary greatly ranging from 0.5 months to 30 years; gastric metastases usually present with non-specific symptoms, even though five patients in case reports were asymptomatic; linitis plastica is the most common endoscopic finding; immunohistochemistry is essential for differentiating primary gastric cancer from metastasis; the preferred treatment is systemic therapy, but surgery is still an option in case of emergency; median overall survival of patients with gastric metastasis from breast cancer is 24 months. Conclusion: Breast metastasis to the stomach should be considered in any patient suspecting gastric neoplasm previously treated for breast carcinoma, especially if the treated carcinoma was ILC.

show abstract

Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach

Cited by 8 publications

References 10 publications

Unusual Presentation of Gastric Outlet Obstruction Due to Breast Cancer Metastasis: A Case Report

Unusual Presentation of Gastric Outlet Obstruction Due to Breast Cancer Metastasis: A Case Report

Gastric Metastasis of Invasive Lobular Breast Carcinoma, a Current Diagnostic and Treatment Challenge - A Review

Breast cancer metastasis to the stomach

Contact Info

Product

Resources

About