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Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma.

Geredeli C, Dogru O, Omeroglu E, Yilmaz F, Cicekci F - Rare Tumors (2015)

Bottom Line: Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas.It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer.Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Konya Training and Research Hospital , Turkey.

ABSTRACT
Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

No MeSH data available.


Related in: MedlinePlus

Tumor infiltration image of gastric metastasis of invasive lobular carcinoma of the breast seen in hematoxilen eosine staining in resected gastric specimen (A) and with positive finding with mammaglobin staining in resected gastric specimen (B). C) Infiltration image of gastric metastasis of invasive lobular carcinoma of the breast with positive finding, and image of gastric glands without staining, performed with GCDFP-15.
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fig002: Tumor infiltration image of gastric metastasis of invasive lobular carcinoma of the breast seen in hematoxilen eosine staining in resected gastric specimen (A) and with positive finding with mammaglobin staining in resected gastric specimen (B). C) Infiltration image of gastric metastasis of invasive lobular carcinoma of the breast with positive finding, and image of gastric glands without staining, performed with GCDFP-15.

Mentions: A 47-year-old female patient was admitted to the General Surgery Department of Konya Training and Research Hospital with a palpable mass in the left breast. Her ultrasonographic breast examination showed a 31×31 mm hypoechoic mass in the upper outer quadrant of the left breast. In addition, breast mammography revealed a 35×26 mm Breast Imaging Reporting and Data System (BI-RADS) 4 mass in the upper outer quadrant of her left breast. The patient was diagnosed with invasive lobular carcinoma through Tru-Cut biopsy in November 2011. On immunohistochemical staining, ER, PR, and HER2 were negative. In whole-body bone scanning, bone metastasis was detected in the T10, T11, L1, L2, L3, and L4 vertebrae. Since the patient was diagnosed with stage IV breast cancer, 6 palliative cycles of 500 mg/m2 fluorouracil, 50 mg/m2 doxorubicin, and 500 mg/m2 cyclophosphamide (FAC) were administered. The patient showed a complete response to the treatment and was followed-up without any medicine for 3 years after the chemotherapy. Positron emission tomography-computed tomography (PET-CT) was performed 3 years later due to an increase seen in the CEA and CA 15-3 values. PET-CT revealed bone metastasis as well as a small wall-thickening mass [standardized uptake value (SUV) maximum value of 5.7] in the corpus area of the stomach (Figure 1). Because a pathologist assessed the condition as primary stomach adenocarcinoma, and the mass was stained negatively with gross cystic disease fluid protein 15 (GCDFP-15), subtotal stomach resection was surgically performed. In the pathological investigation of the specimen from the gastric resection, metastasis of invasive breast lobular carcinoma was reported (Figure 2). Immunohistochemical staining was performed and showed the tissues were cytokeratin 7 (CK7) positive, CK20 negative, GCDFP-15 positive, and mammaglobin positive. ER, PR, and HER2 were also negative. The patient was administered 6 palliative cycles of paclitaxel in combination with carboplatin chemotherapy. The patient was scored 1 in terms of The Eastern Cooperative Oncology Group (ECOG) performance and has been followed-up with administration of only zoledronic acid per month for the bone metastasis.


Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma.

Geredeli C, Dogru O, Omeroglu E, Yilmaz F, Cicekci F - Rare Tumors (2015)

Tumor infiltration image of gastric metastasis of invasive lobular carcinoma of the breast seen in hematoxilen eosine staining in resected gastric specimen (A) and with positive finding with mammaglobin staining in resected gastric specimen (B). C) Infiltration image of gastric metastasis of invasive lobular carcinoma of the breast with positive finding, and image of gastric glands without staining, performed with GCDFP-15.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508641&req=5

fig002: Tumor infiltration image of gastric metastasis of invasive lobular carcinoma of the breast seen in hematoxilen eosine staining in resected gastric specimen (A) and with positive finding with mammaglobin staining in resected gastric specimen (B). C) Infiltration image of gastric metastasis of invasive lobular carcinoma of the breast with positive finding, and image of gastric glands without staining, performed with GCDFP-15.
Mentions: A 47-year-old female patient was admitted to the General Surgery Department of Konya Training and Research Hospital with a palpable mass in the left breast. Her ultrasonographic breast examination showed a 31×31 mm hypoechoic mass in the upper outer quadrant of the left breast. In addition, breast mammography revealed a 35×26 mm Breast Imaging Reporting and Data System (BI-RADS) 4 mass in the upper outer quadrant of her left breast. The patient was diagnosed with invasive lobular carcinoma through Tru-Cut biopsy in November 2011. On immunohistochemical staining, ER, PR, and HER2 were negative. In whole-body bone scanning, bone metastasis was detected in the T10, T11, L1, L2, L3, and L4 vertebrae. Since the patient was diagnosed with stage IV breast cancer, 6 palliative cycles of 500 mg/m2 fluorouracil, 50 mg/m2 doxorubicin, and 500 mg/m2 cyclophosphamide (FAC) were administered. The patient showed a complete response to the treatment and was followed-up without any medicine for 3 years after the chemotherapy. Positron emission tomography-computed tomography (PET-CT) was performed 3 years later due to an increase seen in the CEA and CA 15-3 values. PET-CT revealed bone metastasis as well as a small wall-thickening mass [standardized uptake value (SUV) maximum value of 5.7] in the corpus area of the stomach (Figure 1). Because a pathologist assessed the condition as primary stomach adenocarcinoma, and the mass was stained negatively with gross cystic disease fluid protein 15 (GCDFP-15), subtotal stomach resection was surgically performed. In the pathological investigation of the specimen from the gastric resection, metastasis of invasive breast lobular carcinoma was reported (Figure 2). Immunohistochemical staining was performed and showed the tissues were cytokeratin 7 (CK7) positive, CK20 negative, GCDFP-15 positive, and mammaglobin positive. ER, PR, and HER2 were also negative. The patient was administered 6 palliative cycles of paclitaxel in combination with carboplatin chemotherapy. The patient was scored 1 in terms of The Eastern Cooperative Oncology Group (ECOG) performance and has been followed-up with administration of only zoledronic acid per month for the bone metastasis.

Bottom Line: Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas.It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer.Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Konya Training and Research Hospital , Turkey.

ABSTRACT
Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

No MeSH data available.


Related in: MedlinePlus