Limits...
Metastatic nonpalpable invasive lobular breast carcinoma presenting as rectal stenosis: a case report.

Osaku T, Ogata H, Magoshi S, Kubota Y, Saito F, Kanazawa S, Kaneko H - J Med Case Rep (2015)

Bottom Line: A 69-year-old Japanese woman presented to our hospital for treatment of constipation.Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause.However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan. tadatoshi.osaku@med.toho-u.ac.jp.

ABSTRACT

Introduction: Invasive lobular carcinomas have an increased propensity for distant metastases, particularly to the peritoneum, ovaries, and uterus. In contrast, distant metastases of nonpalpable lobular carcinomas are extremely rare, and the causes of underlying symptoms of primary carcinomas remain unclear. We report a case of an asymptomatic invasive lobular carcinoma with a primary mammary lesion in a patient with rectal stenosis.

Case presentation: A 69-year-old Japanese woman presented to our hospital for treatment of constipation. Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause. Thus, an exploratory laparotomy and tissue biopsy was performed, and the presence of an invasive lobular carcinoma was confirmed. Subsequent breast examinations showed that the invasive lobular carcinoma that led to the rectal stenosis was a metastatic lesion from a primary lesion of the breast duct. As the present breast lobular carcinoma was asymptomatic and nonpalpable, we did not initially consider metastatic breast cancer as a cause of her symptoms, and the final diagnosis was delayed.

Conclusions: Peritoneal metastasis from nonpalpable invasive lobular carcinomas is very rare. However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.

Show MeSH

Related in: MedlinePlus

A ductal ultrasonogram showing an irregularly shaped mass of approximately 5 × 6mm with unclear boundaries in area C of our patient’s right breast. The internal echogenicity was uneven and the posterior echo was dissipated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4414004&req=5

Fig5: A ductal ultrasonogram showing an irregularly shaped mass of approximately 5 × 6mm with unclear boundaries in area C of our patient’s right breast. The internal echogenicity was uneven and the posterior echo was dissipated.

Mentions: Subsequent mammogram images showed a spiculated structure of lactiferous ducts in area C of her right breast (Figure 4). Moreover, a ductal ultrasonography revealed a lesion of approximately 5 × 6mm in the same area (Figure 5). A subsequent biopsy specimen of the duct showed cells with histopathological characteristics similar to those in her peritoneal nodules.Figure 4


Metastatic nonpalpable invasive lobular breast carcinoma presenting as rectal stenosis: a case report.

Osaku T, Ogata H, Magoshi S, Kubota Y, Saito F, Kanazawa S, Kaneko H - J Med Case Rep (2015)

A ductal ultrasonogram showing an irregularly shaped mass of approximately 5 × 6mm with unclear boundaries in area C of our patient’s right breast. The internal echogenicity was uneven and the posterior echo was dissipated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4414004&req=5

Fig5: A ductal ultrasonogram showing an irregularly shaped mass of approximately 5 × 6mm with unclear boundaries in area C of our patient’s right breast. The internal echogenicity was uneven and the posterior echo was dissipated.
Mentions: Subsequent mammogram images showed a spiculated structure of lactiferous ducts in area C of her right breast (Figure 4). Moreover, a ductal ultrasonography revealed a lesion of approximately 5 × 6mm in the same area (Figure 5). A subsequent biopsy specimen of the duct showed cells with histopathological characteristics similar to those in her peritoneal nodules.Figure 4

Bottom Line: A 69-year-old Japanese woman presented to our hospital for treatment of constipation.Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause.However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Breast and Endocrine Surgery (Omori), Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8451, Japan. tadatoshi.osaku@med.toho-u.ac.jp.

ABSTRACT

Introduction: Invasive lobular carcinomas have an increased propensity for distant metastases, particularly to the peritoneum, ovaries, and uterus. In contrast, distant metastases of nonpalpable lobular carcinomas are extremely rare, and the causes of underlying symptoms of primary carcinomas remain unclear. We report a case of an asymptomatic invasive lobular carcinoma with a primary mammary lesion in a patient with rectal stenosis.

Case presentation: A 69-year-old Japanese woman presented to our hospital for treatment of constipation. Although rectal stenosis was confirmed, thorough testing of her lower digestive tract did not identify its cause. Thus, an exploratory laparotomy and tissue biopsy was performed, and the presence of an invasive lobular carcinoma was confirmed. Subsequent breast examinations showed that the invasive lobular carcinoma that led to the rectal stenosis was a metastatic lesion from a primary lesion of the breast duct. As the present breast lobular carcinoma was asymptomatic and nonpalpable, we did not initially consider metastatic breast cancer as a cause of her symptoms, and the final diagnosis was delayed.

Conclusions: Peritoneal metastasis from nonpalpable invasive lobular carcinomas is very rare. However, breast cancer metastasis should be considered when carcinomatous peritonitis is present in a patient with an unknown primary cancer.

Show MeSH
Related in: MedlinePlus