J Breast Cancer.  2011 Mar;14(1):69-71. 10.4048/jbc.2011.14.1.69.

Solitary Small Bowel Metastasis from Breast Cancer

• Choi JE
• Park SY
• Jeon MH
• Kang SH
• Lee SJ
• Bae YK
• Kim MK

• KMID: 2175646
• DOI: http://doi.org/10.4048/jbc.2011.14.1.69

Abstract

The common sites of metastasis of breast cancer are bone, lung, and liver, but gastrointestinal metastasis from breast cancer is rare. We experienced a case of solitary ileal metastasis from breast cancer. A 45-years-old woman presented with melena for several weeks. She showed no other abdominal symptoms. Colonoscopy findings showed an ulcerative mucosal lesion in the terminal ileum, and biopsy was performed. Pathologic examination revealed metastatic carcinoma, originated from breast. The tumor cells were positive for estrogen receptor and negative for Cdx-2. She had had a previous medical history of bilateral breast cancer and undergone breast conserving surgery with sentinel lymph node biopsy for both breasts. The torso positron emission tomography scan at 19 months after surgery showed mildly increased uptake in the terminal ileum which was considered as inflammation. Finally, she was diagnosed with solitary ileal metastasis from breast cancer at 22 months after surgery.

Keyword

Breast; Gastrointestinal tract; Neoplasm metastasis

MeSH Terms

Biopsy
Breast
Breast Neoplasms
Colonoscopy
Estrogens
Female
Gastrointestinal Tract
Humans
Ileum
Inflammation
Liver
Lung
Mastectomy, Segmental
Melena
Neoplasm Metastasis
Nitriles
Positron-Emission Tomography
Pyrethrins
Sentinel Lymph Node Biopsy
Torso
Ulcer
Estrogens
Nitriles
Pyrethrins

Figure

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  Figure 1 Colonoscopy showed ulcerative mucosa (arrow) in the terminal ileum.

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  Figure 2 (A) Microscopic findings of terminal ileal wall showed tumor emboli infiltrations (arrows) in lamina propria lymphatic spaces, but intact mucosal epithelium (H&E stain, ×100). (B) The tumor cells (arrows) were positive for estrogen receptor; (C) negative for Cdx-2, a critical nuclear transcription factor for intestinal development (immunohistochemical staining, ×100).

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  Figure 3 (A) Microscopic findings of both breast revealed infiltration of malignant ductal cells. The primary invasive ductal carcinomas of breast shows well differentiation and no lymphovascular invasions (H&E stain, ×200). (B) The malignant cells are positive for E-cadherin (immunohistochemical staining, ×200).

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  Figure 4 (A) The torso positron emission tomography scan showed mild uptake in the terminal ileum (SUV max=5.7). (B) The retroperitoneal computed tomography showed thickening of the wall of terminal ileum and multiple lymph node enlargement around them.

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