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A rare presentation of breast cancer: near obstructing rectal mass and gastric outlet obstruction

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ABSTRACT

Breast cancer metastasizes to the gastrointestinal (GI) tract are exceedingly rare. The low incidence and vague presentation of GI metastasizes often cause delay in diagnosis and treatment. Here, we present a case of metastatic breast cancer causing gastric outlet obstruction and rectal obstruction.

No MeSH data available.


Related in: MedlinePlus

Rectal mass biopsy with atypical submucosal infiltrate with stains indicative of poorly differentiated carcinoma with breast primary (left); Gastric mucosa biopsy with poorly differentiated malignant large cell neoplasm, stains consistent with metastatic breast adenocarcinoma (right).
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rjw162F3: Rectal mass biopsy with atypical submucosal infiltrate with stains indicative of poorly differentiated carcinoma with breast primary (left); Gastric mucosa biopsy with poorly differentiated malignant large cell neoplasm, stains consistent with metastatic breast adenocarcinoma (right).

Mentions: A 61-year-old African American female presented to her primary care provider with a 1-month history of nausea, emesis, constipation and 20 pound weight loss. She also reported superficial skin changes on bilateral breasts and a palpable mass in her left breast. Mammography revealed a hypoechoic lesion of the left breast and overlying asymmetry classified as BIRADS 4C which was not present on the patient's annual mammogram 8 months prior. The patient was referred to general surgery for biopsies of the left breast mass, overlying skin of both breasts and an axillary skin lesion. Pathology report of all lesions was ER(−), Her2/neu(−), GATA3(+) poorly differentiated mammary carcinoma. Computed Tomography (CT) scan of chest, abdomen and pelvis was performed for cancer staging. The scan revealed multiple osteoblastic metastasis within the sternum and spine, circumferential rectosigmoid mural thickening and duodenal bulb wall thickening (Fig. 1). The duodenal and rectal lesions were further evaluated with endoscopy. On upper endoscopy there was extrinsic compression of the antrum and stenosis of the pylorus and duodenal bulb. On colonoscopy, there was firm, friable, erythematous stricture circumferentially in the distal 5 cm of rectum (Fig. 2). Pathologic evaluation of the duodenal and rectal lesions revealed poorly differentiated carcinoma consistent with mammary primary (Fig. 3).Figure 1:


A rare presentation of breast cancer: near obstructing rectal mass and gastric outlet obstruction
Rectal mass biopsy with atypical submucosal infiltrate with stains indicative of poorly differentiated carcinoma with breast primary (left); Gastric mucosa biopsy with poorly differentiated malignant large cell neoplasm, stains consistent with metastatic breast adenocarcinoma (right).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5035840&req=5

rjw162F3: Rectal mass biopsy with atypical submucosal infiltrate with stains indicative of poorly differentiated carcinoma with breast primary (left); Gastric mucosa biopsy with poorly differentiated malignant large cell neoplasm, stains consistent with metastatic breast adenocarcinoma (right).
Mentions: A 61-year-old African American female presented to her primary care provider with a 1-month history of nausea, emesis, constipation and 20 pound weight loss. She also reported superficial skin changes on bilateral breasts and a palpable mass in her left breast. Mammography revealed a hypoechoic lesion of the left breast and overlying asymmetry classified as BIRADS 4C which was not present on the patient's annual mammogram 8 months prior. The patient was referred to general surgery for biopsies of the left breast mass, overlying skin of both breasts and an axillary skin lesion. Pathology report of all lesions was ER(−), Her2/neu(−), GATA3(+) poorly differentiated mammary carcinoma. Computed Tomography (CT) scan of chest, abdomen and pelvis was performed for cancer staging. The scan revealed multiple osteoblastic metastasis within the sternum and spine, circumferential rectosigmoid mural thickening and duodenal bulb wall thickening (Fig. 1). The duodenal and rectal lesions were further evaluated with endoscopy. On upper endoscopy there was extrinsic compression of the antrum and stenosis of the pylorus and duodenal bulb. On colonoscopy, there was firm, friable, erythematous stricture circumferentially in the distal 5 cm of rectum (Fig. 2). Pathologic evaluation of the duodenal and rectal lesions revealed poorly differentiated carcinoma consistent with mammary primary (Fig. 3).Figure 1:

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Breast cancer metastasizes to the gastrointestinal (GI) tract are exceedingly rare. The low incidence and vague presentation of GI metastasizes often cause delay in diagnosis and treatment. Here, we present a case of metastatic breast cancer causing gastric outlet obstruction and rectal obstruction.

No MeSH data available.


Related in: MedlinePlus