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Breast cancer metastases to the stomach and colon mimicking primary gastrointestinal cancer: Four cases and literature review

Necdet Uskent ()
Hüseyin Baloğlu ()
Metin Çakmakçı ()
Sezer Saglam ()
Ulkuhan Koksal ()


Intraluminal gastric and colonic metastases of the breast cancer are very rare and may sometimes prove a  diagnostic dilemma to distinguish from primary gastric and colonic cancers. It is important to make the distinction in order to navigate the proper treatment approach, which is a systemic treatment rather than surgery if the disease is me- tastatic. The spread to the gastrointestinal (GI) tract is more frequent in lobular histology and according to a number of investigators, it is related to a particular tropism of lobular cells toward gastrointestinal mucosa. Any region of GI tract may be involved, from the tongue to the anus. Over the last decade, among the 1,100 breast cancer cases registered at our institutions, we diagnosed four patients with breast cancer who had metastases to the stomach and/or colon and presented symptoms that simulated primary gastrointestinal cancer. A total of 84 out of the 1,100 patients experienced invasive lobular histology. Among the four patients with GI tract metastases, three were diagnosed with lobular hist- ology – two of whom had the signet ring cell subtype. The remaining patient was diagnosed with triple negative invasive ductal carcinoma; however, it clinically resembled invasive lobular carcinoma. Clinical and pathological features of these cases, as well as the review of related literature are discussed in this report.


Gastric and colon metastasis of breast cancer; triple negative; invasive lobular carcinoma

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Ambroggi M, Stroppa EM, Mordenti P, Biasini C, Zangrandi A, et al. Metastatic breast cancer to the gastrointestinal tract: Report of five cases and review of the literature. Int J Breast Cancer 2012; 2012(2012). doi: 10.1155/2012/439023.

Wiisanen JM, Kaur JS. Gastrointestinal metastases from breast cancer, a diagnostic dilemma. MOJ Clin Med Case Rep 2015; 2(2): 00014. doi: 10.15406/mojcr.2015.0 2.00014.

Mourra N, Jouret-Mourin A, Lazure T, Audard V, Albiges L, et al. Metastatic tumors to the colon and rectum: A multi-institutional study. Arch Pathol Lab Med 2012; 136(11): 1397–1401. doi: 10.5858/arpa.2011-0432-OA.

Ciriello G, Gatza ML, Beck AH, Wilkerson MD, Rhie SK, et al. Comprehensive molecular portraits of invasive lobular breast cancer. Cell 2015; 163(2): 506–519. doi: 10.1016/j.cell.2015.09.033.

Pestalozzi BC, Zahrieh D, Mallon E, Gusterson BA, Price KN, et al. Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: Combined results of 15 international breast cancer study group clinical trials. J Clin Oncol 2008; 26(18): 3006–3014. doi: 10.120 0/JCO.2007.14.9336.

Taal BG, den Hartog Jager FCA, Steinmetz R, Peterse H. The spectrum of gastrointestinal metastases of breast carcinoma: I. Stomach. Gastrointest Endosc 1992; 38(2): 130– 135. doi: 10.1016/S0016-5107(92)70377-0.

Koninckx PR, Kennedy SH, Barlow DH. Endometriotic disease: The role of peritoneal fluid. Hum Reprod Update 1998; 4(5): 741–751. doi: 10.1093/humupd/4.5.741.

Manucha V, Khilko N, Reilly K, Zhang X. Invasive pleomorphic lobular carcinoma, negative for ER, PR and HER/2neu – A case report. Int J Clin Exp Pathol 2011; 4(2): 200–205.

Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: Tumor characteristics and clinical outcome. Breast Cancer Res 2004; 6(3): R149–R156. doi: 10.1186/bcr767.

Michaut M, Chin SF, Majewski I, Severson TM, Bismeijer T, et al. Integration of genomic, transcriptomic and proteomic data identifies two biologically distinct subtypes of invasive lobular breast cancer. Sci Rep 2016; 6: 18517. doi: 10.1038/srep18517.

Winston CB, Hadar O, Teitcher JB, Caravelli JF, Sklarin NT, et al. Metastatic lobular carcinoma of the breast patterns of spread in the chest, abdomen and pelvis on CT. Am J Roentgenol 2000; 175(3): 795–800. doi: 10.2214/aj r.175.3.1750795.

Switzer N, Lim A, Du L, Al-Sairafi R, Tonkin K, et al. Case series of 21 patients with extrahepatic metastatic lobular breast carcinoma to the gastrointestinal tract. Cancer Treat Commun 2015; 3: 37–43. doi: 10.1016/j.ctr c.2014.11.006.

Raap M, Antonopoulos W, Dämmrich M, Christgen H, Steinmann D, et al. High frequency of lobular breast cancer in distant metastases to the orbit. Cancer Med 2015; 4(1): 104–111. doi: 10.1002/cam4.331.

Lokadasan R, Ratheesan K, Sukumaran R, Nair SP. Metastatic lobular carcinoma of breast mimics cervix carcinoma: Two case reports and review of the literature. Ecancermedicalscience 2015; 9: 571. doi: 10.3332/ecance r.2015.571.

Pekindil G, Solmaz Hasdemir P, Tan A, Goksel G. Breast cancer with silent metastasis to uterine cervix. J Clin Anal Med 2015; 6 (155): 647–649.

Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract: Analysis of 325 cases. Cancer 1984; 53(9): 1978–1984. doi:10.1002/1097-0142(19840501)53:9< 197 8:AID-CNCR2820530929>3.0.CO;2-1.

Pérez-Montiel D, Serrano-Olvera A, Salazar LC, Cetina- Pérez L, Candelaria M, et al. Adenocarcinoma metastatic to the uterine cervix: A case series. J Obstet Gynaecol Res 2012; 38(3): 541–549. doi: 10.1111/j.1447-0756. 2011.0 1747.x

Washington K, McDonagh D. Secondary tumors of the gastrointestinal tract: Surgical pathologic findings and comparison with autopsy survey. Mod Pathol 1995; 8(4): 427–433.

Cifuentes N, Pickren JW. Metastases from carcinoma of mammary gland: An autopsy study. J Surg Oncol 1979; 11(3): 193–205. doi: 10.1002/jso.2930110303.

Borst MJ, Ingold JA. Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery 1993; 114(4): 637–642.

Geredeli C, Dogru O, Omeroglu E. Gastric metastasis of triple negative invasive lobular carcinoma. Rare Tumors 2015; 7(2): 57–59. doi: 10.4081/rt.2015.5764.

Avcı Y, Alabalık U, Fırat U, Urakçı Z, Hamidi C, et al. Östrogen, Progesteron ve Her2/neu Negatif İnvaziv Lobuler Pleomorfik Karsinom: Olgu Sunumu (Turkish) [Oestrogen, progesteron and Her2/neu receptors negative invasive lobular pleomorphic carcinoma: A case report]. Van Tıp Dergisi 2015; 22(2): 108–110.



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