gastric metastasis from breast cancer: case report dott. francesco pontieri (*) uo di anatomia...

GASTRIC METASTASIS FROM BREAST CANCER: CASE REPORT

Dott. Francesco Pontieri (*) UO di Anatomia Patologica

P.O. di Rossano (CS)

Dott. Gianluca DimaUO di Oncologia Medica

P.O. di Paola (CS)

(*) Relatore

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Gastrointestinal metastases arising from breast cancer are rarely found, with an estimated incidence rate of

approximately 0.5%; in 60% of cases, they occur in stomach.

They mainly originate from lobular rather than ductal breast carcinoma.

The reason is unknown, but some authors think that it could be related to a particular tropism of lobular cells.

These metastases are mostly detected within a linitis plastica image (diffuse intramural infiltration by the tumor),

during endoscopic evaluations, while are extremely rare in the early gastric cancer

(EGC) setting.

This case report deals with a gastric metastasis from ductal breast cancer

in a 62 year-old woman, who had previously undergone a left radical

mastectomy for a moderately differentiated grade breast carcinoma

and adjuvant chemotherapy.

An endoscopic biopsy of gastric neoplasm was

performed 14 years later, as she reported

epigastralgia associated with nausea.  

A histologic evaluation highlighted glandular elements

with a predominant tubular growth pattern infiltrating the

lamina propria stroma.

The immunohistochemical evaluation of which was ER-CK7

positive, and PR-CK20-CDX2 negative, confirming the gastric

metastasis from breast carcinoma.

Negative for neuroendocrine tumor: S-100, Chromogranin A, and

Synaptophisin.

Therapeutic Decision

The patients was undergone six courses of docetaxel-based

chemotherapy, reporting a radiologic complete response.

Actually, she is taking hormonal therapy with an aromatase inhibitor.

Conclusion:gastrointestinal metastases from breast carcinoma are rare; in the presence of a

carcinomatous gastric neoplasm in a patient with a clinical history of invasive breast

cancer, we should suppose the probability of a secondary gastric localization. the

histomorphological and immunohistochemical evaluations are essential to make a correct

diagnosis and a consequent adequate therapeutic protocol.

References:1) B.G. Taal, H. Peterse, and H. Boot, “Clinical presentation, endoscopic

features, and treatment of gastric metastases from breast carcinoma”, Cancer, vol. 89, N. 11, pp 2214-2221, 2000,

2) P.G. Chu and L.M. Weiss, “Immunohistochemical characterization of sing-ring cell carcinomas of the stomach, breast and colon”, AJCP, vol. 121, N. 6, pp 884-892, 2004;

3) Wan Kyu Eo, “Breast ancer metastasis to the stomach resembling early gastric cancer”, Cancer Res Treat. 2008; 40(4): 207-210;

4) Titi M.A., Anabtawi A., and Newland A.D., “Isolated gastrointestinal metastasis of the breast carcinoma: a case report”; HPC, case reports in medicine, Vol. 2010, Ar. ID 615923;

5) Ambroggi M. and ot., “Metastatic breast cancer to the G.I. tract: report of five cases and review of the literature”; HPC, IJ of Breast Cancer, Vol. 2012, ID 439023.