Back to Basics: History and Physical Examination Uncover Colonic Metastasis in a Patient With Remote History of Breast Cancer

Higley, Cory; Hsu, Angela; Park, Byoung Uk; Pang, Maoyin

doi:10.14309/crj.0000000000000494

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…The main reasons are the long interval between tumor recurrence, the lack of specific clinical symptoms, and the lack of experience of the receiving doctor. The patients with digestive tract metastasis of breast cancer usually have no specific symptoms, as we summarized in Table 1, the most common symptoms include dyspepsia, nausea, changes of stool frequency (10), vomiting (11), abdominal pain (12), obstruction (13), loss of weight (14), and loss of appetite (20). Some were found during regular follow-up (15)(16)(17)(18)(19).…”

Section: What Is the Implication And What Should Change Now?mentioning

confidence: 99%

Ascending colon metastasis after breast cancer surgery: a case report and literature review

Jia¹,

Huang²,

Li³

2023

Gland Surg

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Background: Breast cancer is the most common cancer in women. The tumor is prone to metastasize in the brain, lung, liver, bone, and other organs; however, generally, it is less likely to metastasize in the digestive tract. Thus, breast cancer metastasizes to colon is rarely happened and easily ignored by clinicians. Such misdiagnosis may lead to delay the further diagnosis and treatment of patients, or even cause the life danger of patients due to the progress of the disease. Therefore, we propose such case reports to arouse clinicians' attention to the rare case of digestive tract metastasis after treatment of breast cancer. We also conducted a retrospective analysis of the relevant case reports. We suggest that because breast cancer with gastrointestinal metastasis rarely occurs, and because of the lack of specificity of syndromes, it is easily misdiagnosed. Thus, the attention of the receiving doctor needs to be drawn to this tumor. We also summarized the specificity and sensitivity of the commonly used immunohistochemical detection indicators of digestive tract metastasis of breast cancer.Case Description: We presented a 67-year-old female went to hospital because of "acute pain in the right lower abdomen", after computed tomography (CT) examination, the patient was diagnosed as "acute appendicitis" and underwent laparoscopic appendectomy (LA), the post-surgery pathology confirmed metastatic carcinoma to the appendix from the breast that was removed 10 years early. The patient first came to our hospital 10 years ago because of the right breast malignant tumor. After modified radical mastectomy for right breast cancer, the patient underwent chemotherapy for 6 cycles. Tamoxifen endocrine therapy was administered after chemotherapy. The patient had a regular follow-up, with no signs of distant metastasis and local recurrence.Conclusions: Metastasis from breast cancer to the gastrointestinal tract is extremely rare. For patients with breast cancer, endoscopy should be adopted as a routine follow-up item. For suspicious lesions found under endoscopy, immunohistochemistry stain should be adopted to ensure the diagnosis. For lesions that are confirmed to be metastatic from breast cancer, proper treatment should be carried out based on patients' condition to improve the prognosis.

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Section: What Is the Implication And What Should Change Now?mentioning

confidence: 99%

Ascending colon metastasis after breast cancer surgery: a case report and literature review

Jia¹,

Huang²,

Li³

2023

Gland Surg

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“…[2][3][4][5][6][7][8] Similarly, researches on breast cancer with colonic metastasis also stay at case reports. [9][10][11][12] It is extremely rare to have both gastric and sigmoid colonic metastases in one case.…”

Section: Introductionmentioning

confidence: 99%

Gastric and Sigmoid Colonic Metastases from Breast Cancer: A Case Report and Literature Review

Huang

Chen

Jin

et al. 2023

Preprint

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Background Breast cancer has become the most commonly diagnosed cancer in the world, but gastrointestinal metastasis from breast cancer is rare. It is extremely rare to have both gastric and sigmoid colonic metastases in one case. For patients considered gastric or colon carcinoma who have a history of breast cancer, it is difficult to identify the origin. Even so, clinicians still need to make accurate diagnosis due to great different treatment principles. Case presentation: We present a case that diagnosed as metachronous gastric and sigmoid colonic metastases from invasive lobular carcinoma of the breast. On June 7, 2021, A 65-year-old female patient came to our department complained recurrent abdominal discomfort for one week. Gastroscopy in our hospital suggested that there was a superficial depressed lesion (type IIC) in her gastric antrum, while pathology indicated poorly differentiated carcinoma. Combined with the patient's breast cancer history and immunohistochemical results, we accurately diagnosed her as gastric metastasis of breast cancer rather than primary gastric cancer. During systematic treatment progress, sigmoid colonic metastasis was detected with colonoscopy on September 19, 2022. Up to May 2023, the patient is still alive with an overall survival greater than 23 months. Conclusions Gastrointestinal metastasis of breast cancer is rare in clinical work, but the incidence of autopsy is up to 15–16%. This phenomenon suggests that some patients with advanced breast cancer have not been accurately diagnosed, which may lead them to receive inappropriate treatment. At present, estrogen/progesterone receptor (ER/PR), GATA binding protein-3 (GATA-3), cytokeratin 7/20 (CK7/20), gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin are the most diagnostic immunohistochemical markers.

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Back to Basics: History and Physical Examination Uncover Colonic Metastasis in a Patient With Remote History of Breast Cancer

Cited by 2 publications

References 6 publications

Ascending colon metastasis after breast cancer surgery: a case report and literature review

Ascending colon metastasis after breast cancer surgery: a case report and literature review

Gastric and Sigmoid Colonic Metastases from Breast Cancer: A Case Report and Literature Review

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