Invasive lobular breast carcinoma metastatic to the colon: a case report of a rare condition and its challenges

ABSTRACT

The most common sites for metastatic breast neoplasm are the bones, lungs, liver, and central nervous system. Metastases to the gastrointestinal tract are rare and especially involve the stomach, more than to the colon. The clinical and radiological presentation of the metastatic disease usually does not aid in making the differential diagnosis between primary neoplastic lesions of the colon or rectum and metastases from breast cancer. This often results in inadequate initial treatment. The clinical, radiological and histopathological diagnoses are challenging, and immunohistochemical analyses become necessary in most cases. Therefore, publication in the medical literature of more cases like this one should be stimulated, with the aim of gaining more data on treatments that are used and hence to clarify what the best approach is, focusing especially on better quality of life and survival for these patients.

RESUMO

Os locais mais comuns de neoplasia metastática da mama são os ossos, pulmões, fígado e sistema nervoso central. As metástases do trato gastrointestinal são raras e envolvem especialmente o estômago, mais do que o cólon. A apresentação clínica e radiológica da doença metastática geralmente não ajuda a fazer o diagnóstico diferencial entre lesões neoplásicas primárias do cólon ou reto e metástases de câncer de mama. Isso geralmente resulta em tratamento inicial inadequado. Os diagnósticos clínico, radiológico e histopatológico são desafiadores, e análises imunohistoquímicas tornam-se necessárias na maioria dos casos. Portanto, deve-se estimular a publicação na literatura médica de mais casos como este, com o objetivo de se obter mais dados sobre os tratamentos que são utilizados e, assim, esclarecer qual é a melhor abordagem, com foco principalmente na melhor qualidade de vida e sobrevida destes pacientes.

Keywords:

Lobular breast carcinoma - Breast neoplasm - Neoplasm metastasis - Gastrointestinal cancer.

Descritores:

Carcinoma lobular da mama - Neoplasia da mama - Metástase de neoplasia - Câncer gastrointestinal.

Publikationsverlauf

Eingereicht: 19. Mai 2020

Angenommen: 09. Oktober 2020

Artikel online veröffentlicht:
18. Januar 2021

• REFERENCES

• Gizzi G, Santini D, Guido A, Fuccio L.. Single colonic metastasis from breast cancer 11 years after mastectomy. BMJ Case Rep 2015; 2015: bcr2015211193
• McLemore EC, Pockaj BA, Reynolds C, Gray RJ, Hernandez JL, Grant CS. et al Breast cancer: presentation and intervention in women with gastrointestinal metastases and carcinomatosis. Ann Surg Oncol 2005; Nov; 12 (11) 886-894
• Taal BG, Peterse H, Boot H.. Clinical presentation, endoscopic features, and treatment of gastric metastases from breast carcinoma. Cancer 2000; Dec; 89 (11) 2214-2212
• Ministério da Saúde (BR). Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Estimativa 2020: incidência de câncer no Brasil [Internet]. Brasília (DF): Ministério da Saúde/INCA;; 2020. access in 2020 May 19 Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/estimativa-2020incidencia-de-cancer-no-brasil.pdf
• Borst MJ, Ingold JA.. Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery 1993; Oct; 114 (04) 637-642
• Schwarz RE, Klimstra DS, Turnbull AD.. Metastatic breast cancer masquerading as gastrointestinal primary. Am J Gastroenterol 1998; Jan; 93 (01) 111-114
• Bamias A, Baltayiannis G, Kamina S, Fatouros M, Lymperopoulos E, Agnanti N. et al Rectal metastases from lobular carcinoma of the breast: report of a case and literature review. Ann Oncol 2001; 12: 715-718
• Cervi G, Vettoretto N, Vinco A, Cervi E, Villanacci V, Grigolato P. et al Rectal localization of metastatic lobular breast cancer: report of a case. Dis Colon Rectum 2001; 44: 453-455
• Washington K, McDonagh D.. Secondary tumours of the gastrointestinal tract: surgical pathologic findings and comparison with autopsy series. Mod Pathol 1995; 8 (04) 427-433
• Orvieto E, Maiorano E, Bottiglieri L, Maisonneuve P, Rotmensz N, Galimberti V. et al Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution. Cancer 2008; Oct; 113 (07) 1511-1520
• Ferlicot S, Vincent-Salomon A, Médioni J, Genin P, Rosty C, Sigal-Zafrani B. et al Wide metastatic spreading in infiltrating lobular carcinoma of the breast. Eur J Cancer 2004; Feb; 40 (03) 336-334
• Mathew A, Rajagopal PS, Villgran V, Sandhu GS, Jankowitz RC, Jacob M. et al Distinct pattern of metastases in patients with invasive lobular carcinoma of the breast. Geburtshilfe Frauenheilkd 2017; Jun; 77 (06) 660-666
• Langley RR, Fidler IJ.. The seed and soil hypothesis revisited - the role of tumor- stroma interactions in metastasis to different organs. Int J Cancer 2011; Jun; 128 (11) 2527-2535
• Law WL, Chu KW.. Scirrhous colonic metastasis from ductal carcinoma of the breast. Dis Colon Rectum 2003; Oct; 46 (10) 1424-1427
• Ciulla A, Castronovo G, Tomasello G, Maiorana AM, Russo L, Daniele E. et al Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems. World J Surg Oncol 2008; Jul; 6: 78
• Pectasides D, Psyrri A, Pliarchopoulou K, Pliarchopoulou K, Floros T, Papaxoinis G. et al Gastric metastases originating from breast cancer: report of 8 cases and review of the literature. Anticancer Res 2009; 29 (11) 4759-4764
• Berx G, Cleton-Jansen AM, Strumane K, Leeuw WJ, Nollet F, Van Roy F. et al E-cadherin is inactivated in a majority of invasive human lobular breast cancers by truncation mutations throughout its extracellular domain. Oncogene 1996; Nov; 13 (09) 1919-1925
• Leeuw WJ, Berx G, Vos CB, Peterse JL, Van de Vijver MJ, Litvinov S. et al Simultaneous loss of E-cadherin and catenins in invasive lobular breast cancer and lobular carcinoma in situ. J Pathol 1997; Dec; 183 (04) 404-411
• Madeya S, Börsch G.. Upper intestinal endoscopy in 188 bronchialcancer and 118 breast cancer patients with abdominal symptoms. The GI Metastases Stud Group. Med Klin 1992; Dec; 87 (12) 631-636
• Kaufman O, Deidesheimer T, Muelhenberg M, Deicke P, Dietel M.. Immunohistochemical differentiation of metastatic breast carcinomas from metastatic adenocarcinomas of other common primary sites. Histopathology 1996; Sep; 6 (03) 516-520
• Voravud N, El-Naggar AK, Balch CM, Theriault RL.. Metastatic lobular breast carcinoma simulating primary colon cancer. Am J Clin Oncol 1992; Aug; 15 (04) 365-369
• Signorelli C, Pomponi-Formiconi D, Nelli F, Pllera CF.. Single colon metastasis from breast cancer: a clinical case report. Tumori 2005; Sep/Oct; 91 (05) 424-427
• Villa Guzmán JC, Espinosa J, Cervera R, Delgado M, Patón R, García JMC.. Gastric and colon metastasis from breast cancer: case report, review of the literature, and possible underlying mechanisms. Breast Cancer (Dove Med Press) 2016; Dec; 9: 1-7