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Mentions: The CT Thorax and Abdomen scan showed thickening of the gastric antrum (Fig. 1) in additional to widespread lymphadenopathy in the greater omentum/mesentery (Fig. 2), the appearances were suggestive of gastric cancer. The CT scan also showed a coincidental finding of a left breast cancer (Fig. 3) with left axillary lymphadenopathy (Fig. 4). On further questioning the patient had been aware of the breast lump for 18 months but did not seek medical advice. Following the CT she underwent a mammogram which confirmed the left side breast cancer (Fig. 5).
An Effect of Letrozole on Gastric Cancer?
Bottom Line: Investigations confirmed the presence of two different primary tumours in the left breast and the stomach.Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer.Further studies are needed.
Affiliation: Department of General Surgery, Aneurin Bevan Healthcare NHS Trust Nevill Hall Hospital, Wales, United Kingdom.
Letrozole is a drug used in the treatment of postmenopausal women with breast and ovarian tumours. There is no evidence in the literature indicating its use in treating gastric cancer. We present a 68 year old lady admitted from the emergency department with weight loss, malaise and anaemia. Investigations confirmed the presence of two different primary tumours in the left breast and the stomach. Following that this patient with oestrogen receptor positive breast cancer and oestrogen receptor negative gastric cancer was treated with letrozole for her breast cancer followed by a gastric resection. Independent histology by two pathologists pre-operatively diagnosed gastric adenocarcinoma. Post-operatively, independent analysis of the resected stomach, omentum and lymph nodes revealed no evidence of gastric cancer. Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer. Further studies are needed.