scholarly journals Metastatic Lobular Breast Cancer Mimicking Colitis

Reports ◽  
2020 ◽  
Vol 3 (3) ◽  
pp. 20
Author(s):  
Renata Reis Figueiredo ◽  
Tatiana Strava Correa ◽  
Carlos Henrique dos Anjos ◽  
Heinrich Bender Kohnert Seidler

Breast cancer is the most frequent cancer diagnosed in women in the world regardless of race or ethnicity. About 10% of invasive breast carcinomas are lobular subtype. The loss of the E-caderin expression that occurs in lobular carcinoma leads to a higher risk of metastases in membranes (meningeal, pleural, peritoneum) and gastrointestinal and/or endobronchial mucous, which may lead to several odd symptomatology. We report a 79 years old female patient with lobular breast cancer associated to CDH1 germline mutation. She was diagnosed with breast cancer in December 2016 after noticing a right-armpit nodule whose pathological examination demonstrated an immunohistochemistry profile compatible with lobular breast carcinoma metastasis and had estrogen receptors 98%, progesterone receptors < 1%, ki67 25%, negative her2 score. Family history of only one paternal uncle with stomach cancer. After two lines of hormone therapy, she had disease progression and started oral chemotherapy with capecitabine. In a few weeks, the patient had refractory diarrhea. At the beginning, it was defined like colitis chemotherapy related. However, the clinical features showed necessity of further investigation. Then, she was diagnosed with CDH1 germline mutation after massive progression at gastrointestinal mucous. This case made possible to inform the family about risk of germline mutation and necessity of genetic counseling.

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Sjoerd F. Bakker ◽  
Willem Moolenaar ◽  
Marije M. van Santen ◽  
Mathijs P. Hendriks

A 70-year-old woman with a history of lobular breast cancer presented to our Outpatient Clinic with diarrhoea for the past 3 years. Clinical examination and laboratory research were normal. Colonoscopy showed diffuse mild erythema and a decreased vascular pattern. Biopsies from the ascending colon, transverse colon, and descending colon showed metastases of lobular breast carcinoma. Although gastrointestinal metastases are rare in breast cancer, our case emphasizes the need for further diagnostic efforts in patients with gastrointestinal symptoms and a history of breast carcinoma.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12557-e12557
Author(s):  
Emily Clarke ◽  
James George ◽  
Andrew Peter Dean

e12557 Background: With the exception of malignant melanoma, metastases to the GI tract are rare, especially as a first presentation of malignancy. We report a series of patients with GI metastases from lobular breast carcinoma as an unusual source of symptomatic GI bleeding. Methods: We conducted an electronic database search to identify solid tumour patients (excluding melanoma) with metastases to the GI tract. We then analysed the database by tumour type. Results: 3 cases of proven metastasis to the GI tract were identified. All had lobular breast cancer metastases. The database contained 240 patients with breast cancer, identifying 63 with infiltrating lobular carcinoma, 2 with micropapillary and 175 with invasive ductal carcinoma The 1st case had had invasive ductal breast carcinoma 6 years previously and presented with fatigue and shortness of breath from anaemia. Colonoscopy revealed a polyp which was removed. Histopathology showed metastatic lobular breast carcinoma. Further investigation then confirmed an occult breast mass with identical pathology. The 2nd case presented with 18 months of abdominal pain, previous colonoscopy was normal. After onset of anaemia and 25kg weight loss, upper GI endoscopy showed a markedly thickened stomach with evidence of recent bleeding and biopsies confirmed metastatic lobular breast carcinoma. The 3rd case presented with abdominal pain, subsequent blood tests showing a raised CA125 with omental and ovarian masses. Surgical debulking showed metastatic lobular breast carcinoma, though no primary breast lesion was detectable with mammography, ultrasound and MRI. 3 years later, investigation of anaemia with colonoscopy showed a caecal polyp with histology confirming lobular breast carcinoma. Conclusions: Despite all common tumour types being represented in the database it is notable that all 3 cases with mucosal GI metastases had lobular breast cancer. Previous evidence suggests a long latent period from initial diagnosis of breast cancer to development of GI metastases however our report suggests it can occur earlier in the illness. Clinicians should consider this as a rare cause of GI bleeding and further research to understand the mechanism of mucosal metastasis in lobular breast cancer is needed.


2019 ◽  
pp. 1-3
Author(s):  
Bryce E. Haac ◽  
Jonah N. Rubin ◽  
Andrea Chao Bafford ◽  
Bryce E. Haac ◽  
Fikru Merechi ◽  
...  

Background: A female patient with a history of stage IIB invasive lobular breast cancer presented with symptoms of partial small bowel obstruction and workup led to a presumptive diagnosis of Crohn’s disease. However, at the time of surgical intervention, she was found to have metastatic lobular breast cancer with carcinomatosis and metastases to the small and large intestines. Summary: Our patient presented at age 55 with intermittent nausea and vomiting, dyspepsia, altered bowel habits, and weight loss. She had a history of invasive lobular carcinoma of the right breast treated with right modified radical mastectomy followed by adjuvant chemoradiation and hormonal therapy 5 years earlier. She was thought to be in remission. Initial workup of her GI complaints was notable for thickening of the sigmoid colon and hepatic flexure on CT scan and stricturing and colitis in these areas on colonoscopy. Mucosal biopsies showed nonspecific active colitis. The patient was treated for a presumptive diagnosis of Crohn’s disease without significant improvement. She was eventually taken for surgery after presenting with a high-grade small bowel obstruction. On exploration, numerous additional small and large bowel strictures, some associated with intraluminal masses, were found and a small bowel resection and ileostomy performed. Pathology revealed metastatic invasive lobular breast carcinoma. Although isolated metastases to the bowel wall are rare, they have been reported secondary to a wide range of malignancies. Breast cancer, especially lobular carcinoma, is one of the most common tumors to metastasize to the GI tract and can present years after the primary cancer diagnosis. Therefore, the differential diagnosis for a patient with signs and symptoms of bowel obstruction and a history of lobular breast cancer should include metastatic disease. Conclusion: Metastatic cancer to the GI tract can mimic Crohn’s disease and should be on the differential in older patients with abdominal complaints, particularly those with a history of breast cancer.


2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Tegan Miller ◽  
Carol Ross ◽  
Haitham Al-Rawi ◽  
Barry Taylor ◽  
Mohammad Al-Jafari

Breast cancer rarely metastasises to the gastrointestinal tract. Lobular carcinoma more commonly metastasises to the uterus and appendages, peritoneum, and gastrointestinal tract than other types of breast cancer, while ductal carcinoma has a propensity to metastasise to the lungs, liver, and brain. We describe the case of a patient with no known history of breast cancer, whose primary presentation of lobular breast cancer was with malignant small intestinal and colonic strictures, with coexisting previously undiagnosed adenocarcinoma of the colon.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Asma Hadhri ◽  
Rim Abidi ◽  
Najet Mahjoub ◽  
Alia Mousli ◽  
Khalil Mahjoubi ◽  
...  

Abstract Background Breast cancer is the leading cause of cancer death in women, and most breast cancer related deaths are due to metastasis. Urinary bladder metastasis from breast cancer is rarely reported in the literature. Case presentation We report a case of a 77-year-old female with history of left breast cancer, who presented a thickening of the bladder wall at pelvic ultrasound. Biopsy confirmed that the origin was lobular carcinoma of breast origin. The patient received chemotherapy, but the clinical course of the patient was very aggressive and she died one year later. Conclusion Bladder metastasis from breast cancer is rare, but the literature reveals an increase in such occurrence over the last few years. Pathologic diagnosis relies on immunohistochemical studies. Chemotherapy and hormonal treatment represent the standard therapy, with radiotherapy being used only to control bladder bleeding. The prognosis is usually poor.


2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Nadeem Bilani ◽  
Leah Elson ◽  
Diane Carlson ◽  
Elizabeth Blessing Elimimian ◽  
Zeina Nahleh

Herein, we present a case of a male patient with breast cancer and a recent history of COVID-19 pneumonia, diagnosed with pseudofungi on pathological examination of lymph nodes after mastectomy. Pseudofungi are septate hyphae-like structures that morphologically mimic fungal elements despite the absence of true mycosis and thus predispose to overtreatment if not properly identified. We report a review of similar cases involving this diagnostic mimicker in the literature.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2090720
Author(s):  
Mariangela Gomez ◽  
Kerry Whitting ◽  
Rana Naous

Metastatic carcinomas to the uterus are rare and usually originate from nearby gynecologic sites, most commonly from the ovaries. Among non-gynecologic origins, breast tumors are the most frequent primaries, predominantly the lobular carcinoma type. A 69-year-old postmenopausal woman diagnosed with lobular breast carcinoma 5 years ago, status post modified radical mastectomy, and currently on tamoxifen therapy presented with post-menopausal bleeding. Subsequent endometrial biopsy confirmed the diagnosis of metastatic lobular breast carcinoma to the endometrium. Breast carcinomas rarely metastasize to the uterus, especially lobular carcinoma type. Abnormal uterine bleeding in a patient with known history of breast carcinoma and under tamoxifen therapy should prompt a complete diagnostic workup to rule out metastatic disease.


2017 ◽  
Vol 20 (3) ◽  
pp. 310 ◽  
Author(s):  
Kyong-Ah Yoon ◽  
Sun-Young Kong ◽  
Eun Ji Lee ◽  
Jeong Nam Cho ◽  
Suhwan Chang ◽  
...  

2018 ◽  
Vol 55 (7) ◽  
pp. 431-441 ◽  
Author(s):  
Giovanni Corso ◽  
Joana Figueiredo ◽  
Carlo La Vecchia ◽  
Paolo Veronesi ◽  
Gabriella Pravettoni ◽  
...  

Recent studies have reported germline CDH1 mutations in cases of lobular breast cancer (LBC) not associated with the classical hereditary diffuse gastric cancer syndrome. A multidisciplinary workgroup discussed genetic susceptibility, pathophysiology and clinical management of hereditary LBC (HLBC). The team has established the clinical criteria for CDH1 screening and results’ interpretation, and created consensus guidelines regarding genetic counselling, breast surveillance and imaging techniques, clinicopathological findings, psychological and decisional support, as well as prophylactic surgery and plastic reconstruction. Based on a review of current evidence for the identification of HLBC cases/families, CDH1 genetic testing is recommended in patients fulfilling the following criteria: (A) bilateral LBC with or without family history of LBC, with age at onset <50 years, and (B) unilateral LBC with family history of LBC, with age at onset <45 years. In CDH1 asymptomatic mutant carriers, breast surveillance with clinical examination, yearly mammography, contrast-enhanced breast MRI and breast ultrasonography (US) with 6-month interval between the US and the MRI should be implemented as a first approach. In selected cases with personal history, family history of LBC and CDH1 mutations, prophylactic mastectomy could be discussed with an integrative group of clinical experts. Psychodecisional support also plays a pivotal role in the management of individuals with or without CDH1 germline alterations. Ultimately, the definition of a specific protocol for CDH1 genetic screening and ongoing coordinated management of patients with HLBC is crucial for the effective surveillance and early detection of LBC.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Rodolfo Franco-Márquez ◽  
Adrián Gerardo Torres-Gaytán ◽  
Marcela Anahí Narro-Martinez ◽  
Anahí Carrasco-Chapa ◽  
Benjamín Gómez Núñez ◽  
...  

There are few reports of breast cancer cases with uterine metastases. Here, we report a metastatic lobular carcinoma to endometrium presenting as abnormal uterine bleeding. Diagnosis was based in previous lobular breast carcinoma and immunohistochemistry.


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