Gastric metastases from primary breast cancers: rare causes of common gastrointestinal disorders

We report two cases of gastric metastases from primary breast cancers. In case 1, a 31-year-old woman with right-sided ductal breast carcinoma presented with nausea, vomiting and frank haematemesis, 8 months after mastectomy and adjuvant chemotherapy. An esophagogastroduodenoscopy (EGD) revealed multiple ulcerated gastric lesions secondary to metastatic adenocarcinoma from primary breast tumour. In case 2, an 84-year-old woman with a history of left lobular carcinoma presented with early satiety, 17 years after initial mastectomy and adjuvant endocrine therapy. An EGD revealed unspecific gastric mucosa with thickened and erythematous folds and biopsies revealed adenocarcinoma from primary breast carcinoma. Our cases demonstrate how gastric metastases have variable, non-specific clinical and endoscopic presentations. Symptoms may include nausea, vomiting, early satiety and gastrointestinal (GI) bleeding. Endoscopic appearance may range from thickened gastric folds to ulcerating lesions. Our cases demonstrate that gastric metastases should be considered in patients with breast cancer history presenting with GI symptoms.

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Lobular breast carcinoma metastatic to the endometrium in a patient under tamoxifen therapy: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x20907208 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2090720

Author(s):

Mariangela Gomez ◽

Kerry Whitting ◽

Rana Naous

Keyword(s):

Breast Carcinoma ◽

Lobular Carcinoma ◽

Radical Mastectomy ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Tamoxifen Therapy ◽

History Of ◽

Lobular Breast Carcinoma ◽

Post Menopausal ◽

Rule Out

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.

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Skin Nodules as a First Presentation of Synchronous Bilateral Invasive Lobular Breast Carcinoma: A Case Report

Journal of Global Radiology ◽

10.7191/jgr.2021.1147 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sara Khodair ◽

Iman Ewais ◽

Hanaa Abolmagd ◽

Rehab El Sheikh ◽

Sughra Raza ◽

...

Keyword(s):

Breast Carcinoma ◽

Type Ii Diabetes ◽

Lobular Carcinoma ◽

Skin Lesions ◽

Adult Women ◽

Breast Lump ◽

Skin Metastases ◽

History Of ◽

Skin Nodules ◽

Lobular Breast Carcinoma

The most common cause of skin metastases in adult women is primary breast carcinoma, which comprises about 70% of cases [1]. Skin metastases have non-specific clinical appearances, making it challenging to differentiate them from other benign conditions [1]. We present a case of a 52-year-old female with type II diabetes and a three-month history of refractory skin lesions who did not respond to anti-inflammatory treatment. The patient subsequently complained of a right breast lump, evaluation of which led to the diagnosis of bilateral synchronous invasive lobular carcinoma.

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Metastatic Breast Carcinoma to The Uterine Cervix - An Unusual Presentation

Annals of Pathology and Laboratory Medicine ◽

10.21276/apalm.2944 ◽

2021 ◽

Vol 8 (2) ◽

pp. C32-34

Author(s):

Maymol P Varghese ◽

Sreeja Raju ◽

Savithri MC ◽

Joy Augustine ◽

Mathew Varghese

Keyword(s):

Breast Carcinoma ◽

Uterine Cervix ◽

Lobular Carcinoma ◽

Metastatic Breast ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Present Case Report ◽

Metastatic Breast Carcinoma ◽

History Of ◽

A Site

Uterine cervix involvement as a site of metastasis from a distant primary tumor is rare. Metastasis from breast carcinoma in a patient undergoing treatment is even rarer. The present case report is of a 47-year-old lady with history of carcinoma breast on treatment and who was referred to our hospital with complaints of lower limb oedema, low backache and postmenopausal whitish discharge per vaginum. Per vaginal examination revealed a lesion arising in the cervix extending up to the anterior vaginal wall suggestive of a clinical diagnosis of carcinoma cervix. Subsequent biopsy from the lesion showed malignant cells arranged in Indian file pattern and focal alveolar pattern, hinting at a diagnosis of Invasive lobular carcinoma metastasis. The neoplasm was positive for ER, PR and GATA-3 and negative for Her2/neu and E-cadherin confirming our diagnosis. Although rare, the poor outcome in such patients makes it even more important for its identification and the need for them to undergo careful routine gynecologic examination.

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Multiple trichoepithelioma and breast carcinoma. Simultaneous appearance of epithelioma adenoides cysticum and infiltrating lobular carcinoma of the breast

Archives of Dermatology ◽

10.1001/archderm.114.8.1230 ◽

1978 ◽

Vol 114 (8) ◽

pp. 1230-1230 ◽

Cited By ~ 1

Author(s):

M. Sandbank

Keyword(s):

Breast Carcinoma ◽

Lobular Carcinoma ◽

Carcinoma Of The Breast

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Breast carcinoma in young females below the age of 35 years - histopathological and prognostic significance

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i3.6021 ◽

1970 ◽

Vol 2 (3) ◽

pp. 198-202

Author(s):

D Ghartimagar ◽

A Ghosh ◽

OP Talwar ◽

R Narasimhan

Keyword(s):

Breast Carcinoma ◽

Young Women ◽

Early Stage ◽

Prognostic Significance ◽

Age Group ◽

Breast Cancers ◽

Young Females ◽

Younger Age ◽

Grade 3 ◽

Group Grade

Background: Breast cancers rarely occur in young women but are known to have more aggressive behaviors and poorer outcome. We here compare the significance of breast carcinoma in female below the age of 35 to the age over 35 whose specimens were submitted to Manipal teaching hospital, Pokhara. Materials and Methods: All cases of mastectomy with carcinoma from January 2000 to September 2011 were included in the study. Clinical and histopathological datas of all cases were reviewed and collated. Results: A total of 148 mastectomy specimens were received, among which, 23 cases (16%) were below 35 years; whereas 125 cases (84%) were above 35 years of age. In both groups, Stage II was the commonest stage but stage III was much more common in older group (33% versus 9%) and stage I was more common in younger age group (39% versus 27%). Bloom Richardson grading showed that in the older age group, grade 1 is the commonest grade (50%) while in the younger group; grade 3 is the commonest (39%). Patients were followed for a varying period of 6 months to 5 years. Two cases (2% of followed up cases) in older group and 3 cases (15% of followed up cases) in the younger group showed recurrence. Conclusion: Breast carcinoma in the patients younger than 35 years though presented at an early stage has higher grade tumor and poorer outcome. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6021 JPN 2012; 2(3): 198-202

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Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽

10.3390/cancers13112506 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2506

Author(s):

Mark van Barele ◽

Bernadette A. M. Heemskerk-Gerritsen ◽

Yvonne V. Louwers ◽

Mijntje B. Vastbinder ◽

John W. M. Martens ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative ◽

Hormone Replacement ◽

Breast Cancers ◽

Younger Women ◽

Alternative Pathways ◽

Increased Risk ◽

History Of ◽

Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

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Effect of prior cancer on survival outcomes for patients with advanced prostate cancer

BMC Urology ◽

10.1186/s12894-021-00792-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yechen Wu ◽

Xi Chen ◽

Duocheng Qian ◽

Wei Wang ◽

Yiping Zhang ◽

...

Keyword(s):

Prostate Cancer ◽

Clinical Outcomes ◽

Cancer Diagnosis ◽

Advanced Prostate Cancer ◽

Lymphocytic Leukemia ◽

Cancer History ◽

Non Hodgkin Lymphoma ◽

Kaplan Meier ◽

History Of ◽

The Impact

Abstract Background A history of prior cancer commonly results in exclusion from cancer clinical trials. However, whether a prior cancer history has an adversely impact on clinical outcomes for patients with advanced prostate cancer (APC) remains largely unknown. We therefore aimed to investigate the impact of prior cancer history on these patients. Methods We identified patients with advanced prostate cancer diagnosed from 2004 to 2010 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan–Meier method and the Cox proportional hazard model were utilized for survival analysis. Results A total of 19,772 eligible APC patients were included, of whom 887 (4.5 %) had a history of prior cancer. Urinary bladder (19 %), colon and cecum (16 %), melanoma of the skin (9 %) malignancies, and non-hodgkin lymphoma (9 %) were the most common types of prior cancer. Patients with a history of prior cancer had slightly inferior overall survival (OS) (AHR = 1.13; 95 % CI [1.02–1.26]; P = 0.017) as compared with that of patients without a prior cancer diagnosis. Subgroup analysis further indicated that a history of prior cancer didn’t adversely impact patients’ clinical outcomes, except in patients with a prior cancer diagnosed within 2 years, at advanced stage, or originating from specific sites, including bladder, colon and cecum, or lung and bronchus, or prior chronic lymphocytic leukemia. Conclusions A large proportion of APC patients with a prior cancer history had non-inferior survival to that of patients without a prior cancer diagnosis. These patients may be candidates for relevant cancer trials.

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Acute appendicitis as an unusual cause of invasive ductal breast carcinoma metastasis

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa535 ◽

2020 ◽

Vol 2020 (12) ◽

Author(s):

Vincent De Pauw ◽

Julie Navez ◽

Stephane Holbrechts ◽

Jean Lemaitre

Keyword(s):

Abdominal Pain ◽

Breast Carcinoma ◽

Acute Appendicitis ◽

Ductal Carcinoma ◽

Hormonal Treatment ◽

Locoregional Therapy ◽

Invasive Ductal Breast Carcinoma ◽

Ductal Breast Carcinoma ◽

History Of ◽

Anticancer Treatment

Abstract Acute appendicitis is one of the most common causes of abdominal pain at the emergency room. In rare cases, it can be caused by malignancy, even metastatic lesions from extra-abdominal neoplasia. Herein, we report a case of a 64-year-old female with a history of invasive ductal carcinoma of the breast treated by chemotherapy, surgery, radiotherapy and hormonotherapy, relapsing several years later as a bone and a pleura metastasis successfully cured by locoregional therapy and hormonal treatment. She presented with acute abdominal pain without signs of peritonitis. Abdominal computed tomodensitometry showed sign of appendicitis. Therefore, laparoscopic exploration and appendicectomy was performed. During surgery, multiple peritoneal nodules were found and harvested. Pathology showed metastatic nodules of invasive ductal breast carcinoma, including in the appendicular wall, concluding to peritoneal carcinomatosis. The postoperative course was uneventful, but the patient died 1 year later after refusing anticancer treatment.

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170 Primary Breast Lymphoma-Mimicking Inflammatory Breast Disease: A Case Report

British Journal of Surgery ◽

10.1093/bjs/znab134.199 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Alam ◽

B Basak ◽

A Ahsan ◽

A S Gupta ◽

S Islam ◽

...

Keyword(s):

Breast Carcinoma ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Primary Breast Lymphoma ◽

Palpable Mass ◽

Large B Cell Lymphoma ◽

Breast Lymphoma ◽

History Of ◽

Large B Cell

Abstract Primary breast lymphoma (PBL) is an unusual clinical entity accounting for 0.4–0.5% of all breast neoplasms. The usual presentation includes a painless palpable mass similar to that of breast carcinoma. Diffuse large B-cell lymphoma (DLBCL) is the most common identifiable type of PBL based on the histopathological examination. We report an unusual case of 22 years old Bangladeshi woman presented with a 6-month history of a lump on left breast. Although the lump was initially small, it began a rapid growth after 4 months. The swelling was localized and did not show any skin involvement or discharge and as she didn’t have any positive familial history of breast carcinoma her primary attending physician diagnosed it as a case of breast abscess. When local incision and drainage proved ineffective, she was referred to us. After doing an immunohistochemistry from incisional biopsy the diagnosis was confirmed as Diffuse Large B-cell Lymphoma. The patient was treated initially by chemotherapy with CHOP therapy followed by wide local excision. Early and accurate diagnosis of PBL is crucial for selecting the appropriate MDT treatment strategies to avert potentially harmful surgical interventions.

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