Cancer Res Treat.  2008 Dec;40(4):207-210.

Breast Cancer Metastasis to the Stomach Resembling Early Gastric Cancer

• Eo WK

Abstract

Breast cancer metastases to the stomach are infrequent, with an estimated incidence rate of approximately 0.3%. Gastric metastases usually are derived from lobular rather than from ductal breast cancer. The most frequent type of a breast cancer metastasis as seen on endoscopy to the stomach is linitis plastica; features of a metastatic lesion that resemble early gastric cancer (EGC) are extremely rare. In this report, we present a case of a breast cancer metastasis to the stomach from an infiltrating ductal carcinoma (IDC) of the breast in a 48-year-old woman. The patient had undergone a left modified radical mastectomy with axillary dissection nine years prior. A gastric endoscopy performed for evaluation of nausea and anorexia showed the presence of a slightly elevated mucosal lesion in the cardia, suggestive of a type IIa EGC. A histological examination revealed nests of a carcinoma in the subepithelial lymphatics, and immunohistochemical staining for estrogen receptor was positive. This is an extremely rare case with features of type IIa EGC, but the lesion was finally identified as a cancer metastasis to the cardia of the stomach from an IDC of the breast.

Keyword

Breast neoplasms; Stomach neoplasms; Neoplasm Metastasis

MeSH Terms

Anorexia
Breast
Breast Neoplasms
Carcinoma, Ductal
Cardia
Endoscopy
Estrogens
Female
Humans
Incidence
Mastectomy, Modified Radical
Middle Aged
Nausea
Neoplasm Metastasis
Stomach
Stomach Neoplasms
Estrogens

Figure

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  Fig. 1 (A) A gastric endoscopic examination reveals a slightly elevated lesion in the cardia, suggestive of type IIa early gastric caner. (B) An upper gastrointestinal series shows multiple nodular filling defects at the lesser curvature side of the gastric cardia, suggestive of a suspicious early gastric cancer. Gastric motility is not impaired. (C) A coronal view of an abdominal CT scan shows multiple liver metastases. Gastric wall thickening is not seen.

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  Fig. 2 (A) Nests of carcinoma in subepithelial lymphatics are seen (H&E staining, ×100). (B) D2-40 immunostaining is positive for the lymphatic endothelium (arrow) and negative for the capillary endothelium (arrowhead) (Polymer method, ×400) (C) Immunohistochemical staining for estrogen receptor shows strong positivity (×200). (D) GCDFP-15 immunostaining shows positivity for luminal secretion of the tumor glands (Polymer method, ×200).

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