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Breast Cancer Metastasis to the Stomach That Was Diagnosed after Endoscopic Submucosal Dissection

View Article: PubMed Central - PubMed

ABSTRACT

A 52-year-old woman presented with stage IIB primary breast cancer (cT2N1M0), which was treated using neoadjuvant chemotherapy (epirubicin, cyclophosphamide, and paclitaxel). However, the tumor persisted in patchy areas; therefore, we performed modified radical mastectomy and axillary lymph node dissection. Routine endoscopy at 8 months revealed a depressed lesion on the gastric angle's greater curvature, and histology revealed signet ring cell proliferation. We performed endoscopic submucosal dissection for gastric cancer, although immunohistochemistry revealed that the tumor was positive for estrogen receptor, mammaglobin, and gross cystic disease fluid protein-15 (E-cadherin-negative). Therefore, we revised the diagnosis to gastric metastasis from the breast cancer.

No MeSH data available.


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Histological analysis of the left breast. The initial diagnosis was scirrhous carcinoma, because the tumor cells were associated with a dense connective tissue in the stroma. The diagnosis was later revised to invasive lobular carcinoma.
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fig1: Histological analysis of the left breast. The initial diagnosis was scirrhous carcinoma, because the tumor cells were associated with a dense connective tissue in the stroma. The diagnosis was later revised to invasive lobular carcinoma.

Mentions: A 52-year-old woman was diagnosed with stage IIB primary breast cancer in the left breast (cT2N1M0). On immunohistochemical examination, the tumor was positive for estrogen receptor (ER) but was borderline (2+) for human epidermal growth factor receptor 2 (HER2) expression. Fluorescence in situ hybridization revealed that the tumor cells were negative for HER2 amplification. The patient was treated via neoadjuvant chemotherapy with epirubicin and cyclophosphamide, followed by paclitaxel. After the chemotherapy, computed tomography and magnetic resonance imaging revealed that the tumor was still present in patchy areas. Therefore, we performed modified radical mastectomy and axillary lymph node dissection for the left breast cancer. Histological analysis revealed that most of the mammary tissue was hyalinized, due to the effect of the neoadjuvant chemotherapy, and only a few viable carcinoma cells were present. The postsurgical histological diagnosis was scirrhous carcinoma of the left breast that had metastasized to seven lymph nodes in the axillary region (Figure 1). The cancer cells were positive for ER, partially positive for progesterone receptor (PgR), and negative for HER2 expression (1+). Therefore, we started tamoxifen therapy after the surgery, with radiation (50 Gy) of the entire affected area.


Breast Cancer Metastasis to the Stomach That Was Diagnosed after Endoscopic Submucosal Dissection
Histological analysis of the left breast. The initial diagnosis was scirrhous carcinoma, because the tumor cells were associated with a dense connective tissue in the stroma. The diagnosis was later revised to invasive lobular carcinoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120190&req=5

fig1: Histological analysis of the left breast. The initial diagnosis was scirrhous carcinoma, because the tumor cells were associated with a dense connective tissue in the stroma. The diagnosis was later revised to invasive lobular carcinoma.
Mentions: A 52-year-old woman was diagnosed with stage IIB primary breast cancer in the left breast (cT2N1M0). On immunohistochemical examination, the tumor was positive for estrogen receptor (ER) but was borderline (2+) for human epidermal growth factor receptor 2 (HER2) expression. Fluorescence in situ hybridization revealed that the tumor cells were negative for HER2 amplification. The patient was treated via neoadjuvant chemotherapy with epirubicin and cyclophosphamide, followed by paclitaxel. After the chemotherapy, computed tomography and magnetic resonance imaging revealed that the tumor was still present in patchy areas. Therefore, we performed modified radical mastectomy and axillary lymph node dissection for the left breast cancer. Histological analysis revealed that most of the mammary tissue was hyalinized, due to the effect of the neoadjuvant chemotherapy, and only a few viable carcinoma cells were present. The postsurgical histological diagnosis was scirrhous carcinoma of the left breast that had metastasized to seven lymph nodes in the axillary region (Figure 1). The cancer cells were positive for ER, partially positive for progesterone receptor (PgR), and negative for HER2 expression (1+). Therefore, we started tamoxifen therapy after the surgery, with radiation (50 Gy) of the entire affected area.

View Article: PubMed Central - PubMed

ABSTRACT

A 52-year-old woman presented with stage IIB primary breast cancer (cT2N1M0), which was treated using neoadjuvant chemotherapy (epirubicin, cyclophosphamide, and paclitaxel). However, the tumor persisted in patchy areas; therefore, we performed modified radical mastectomy and axillary lymph node dissection. Routine endoscopy at 8 months revealed a depressed lesion on the gastric angle's greater curvature, and histology revealed signet ring cell proliferation. We performed endoscopic submucosal dissection for gastric cancer, although immunohistochemistry revealed that the tumor was positive for estrogen receptor, mammaglobin, and gross cystic disease fluid protein-15 (E-cadherin-negative). Therefore, we revised the diagnosis to gastric metastasis from the breast cancer.

No MeSH data available.


Related in: MedlinePlus