Widespread metastatic breast cancer to the bowel: an unexpected finding during colonoscopy

Abstract

Metastatic neoplasms to the gastrointestinal (GI) tract are an uncommon entity and in extremely rare cases originate from the breast. The clinical manifestations of metastatic breast cancer into the GI tract are frequently non-specific, and the interval between the diagnosis of lobular carcinoma and GI metastasis can often delay up to 30 years. Here, we present a 73-year-old female with an unusual colonoscopy that revealed a submucosa nodular infiltrate throughout all the colon with a cobblestone-like appearance, which was later confirmed to be metastatic lobular carcinoma of the breast that was surgically removed 15 years early. A couple of months later, she developed malignant small bowel obstruction and laparotomy revealed extended small bowel and colonic metastatic involvement.

Breast Cancer Metastasis to the Colon and Rectum: Review of Current Status on Diagnosis and Management

“…These endoscopic features may be indistinguishable from primary colorectal cancer. Moreover, mucosal nodularity and cobblestone-like thickening may mimic crohn's disease 11,15 . The diagnosis is predicated on a detailed pathologic and immunohistochemical (IHC) evaluation 13 , and the pathologist's awareness of the clinical history.…”

Rectal Metastases of Breast Carcinoma: A Case Report

“…Metastasis to the gastrointestinal (GI) tract is uncommon, mainly if breast is the primary site; clinical manifestations are usually non-specific with symptoms related to local factors and extension of the bowel involvement. [1][2][3][4][5][6][7][8][9] Breast cancer affects lymph nodes, bones, lungs, liver, brain, and soft tissues, but rectal spread is very rare. [2][3][4][5][6][7][8][9] Lobular carcinoma is a major subtype in GI implants with up to 18% of incidence.…”

“…[2][3][4][5][6][7][8][9] Lobular carcinoma is a major subtype in GI implants with up to 18% of incidence. 1,2,[4][5][6][7][8][9] The period between the primary tumor diagnosis and evidence of implants is variable and reported to be up to 30 years. 1,4,8,9 The diagnosis of breast cancer ocasionally occurs after manifestations of the rectal metastases.…”

“…1,2,[4][5][6][7][8][9] The period between the primary tumor diagnosis and evidence of implants is variable and reported to be up to 30 years. 1,4,8,9 The diagnosis of breast cancer ocasionally occurs after manifestations of the rectal metastases. 5,8 Worthy of note is a long time after the surgical treatment of breast cancer before the first manifestations and diagnosis of metastasis, increasing the diagnostic challenges as well as the unfavorable outcomes.…”

“…5,8 Worthy of note is a long time after the surgical treatment of breast cancer before the first manifestations and diagnosis of metastasis, increasing the diagnostic challenges as well as the unfavorable outcomes. [1][2][3] Up to 30% of breast cancers metastases occur after treatment, and 5%-10% are in stage IV. 8 The authors believe that case reports may increase awareness of this very rare condition.…”