Gastrointestinal tract metastasis presenting as intussusception in invasive lobular carcinoma of the breast: A case report

Abstract

HighlightsGastrointestinal (GI) tract metastasis in breast cancer is rare and occurs more commonly in invasive lobular carcinoma.The interval between the index breast cancer and GI tract spread may be as long as 30 years.20% of patients with GI tract metastasis are asymptomatic, and detection may rely on physical examination and imaging.Management follows the principles of treatment in systemic disease in breast cancer, with consideration for surgery in obstruction, perforation or bleeding.

Metastatic Invasive Lobular Carcinoma of Bilateral Breasts Presenting with an Abdominal Mass

“…11,15 Gastrointestinal (GI) metastases from breast cancer are rare and may masquerade as primary tumours with non-specific symptoms such as epigastric pain, dyspepsia, bloating, diarrhea, nausea and vomiting, loss of appetite and weight loss, bowel obstruction, anemia and bleeding. [4][5][6][7][8]16 Due to their infiltrative pattern, imaging findings are also nonspecific, adding to the difficulty in differentiating GI metastases from primary GI malignancy or inflammatory bowel disease. Establishing the correct diagnosis is vital as treatment for primary GI malignancy usually involves surgical resection while breast cancer GI metastases are usually treated with systemic chemotherapy and/or hormonal therapy.…”

“…Establishing the correct diagnosis is vital as treatment for primary GI malignancy usually involves surgical resection while breast cancer GI metastases are usually treated with systemic chemotherapy and/or hormonal therapy. 4,6,16 They also have different prognosis, with the latter faring better compared to patients with stage IV gastric cancer. 17 Primary GI tumours are often seen as exophytic or focal masses, while GI metastases from the breasts, especially from ILC, should be considered when there is circumferential, nodular and diffuse infiltration seen, especially in the stomach.…”

“…2,3 Breast cancers metastases may occur in the early presymptomatic stage, along the course of the disease or remain dormant for years before becoming clinically evident. [4][5][6][7][8] The most common sites of breast cancer metastases are the liver, lung, pleura, brain and bone. Gastrointestinal, peritoneal, gynaecological and renal metastases are less common, often masquerading as primary malignancies and causing diagnostic confusion, mostly occurring in ILC as compared to IDC.…”

“…Gastrointestinal, peritoneal, gynaecological and renal metastases are less common, often masquerading as primary malignancies and causing diagnostic confusion, mostly occurring in ILC as compared to IDC. [4][5][6][7][8][9][10] We present a case of a young woman with an enlarging abdominal mass in which the final diagnosis turned out to be gastrointestinal metastasis from ILC of bilateral breasts.…”

Association of variably methylated tumour DNA regions with overall survival for invasive lobular breast cancer

“…This occult nature may explain the detection of ILBC cases at advanced stages [ 4 , 24 – 26 ]. ILBCs display a unique metastatic behaviour and often metastasis to the gastrointestinal tract [ 27 , 28 ], colon [ 29 ], ovaries [ 30 ] and uterus [ 31 ], which is uncommon for other breast cancers types.…”