Transcript Diapositiva 1

GASTRIC METASTASIS FROM BREAST
CANCER: CASE REPORT
Dott. Francesco Pontieri (*)
UO di Anatomia Patologica
P.O. di Rossano (CS)
Dott. Gianluca Dima
UO di Oncologia Medica
P.O. di Paola (CS)
(*) Relatore
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Gastrointestinal metastases arising
from breast cancer are rarely found,
with an estimated incidence rate of
approximately 0.5%; in 60% of cases,
they occur in stomach.
They mainly originate from lobular
rather than ductal breast carcinoma.
The reason is unknown, but some
authors think that it could be related to
a particular tropism of lobular cells.
These metastases are mostly detected
within a linitis plastica image (diffuse
intramural infiltration by the tumor),
during endoscopic evaluations, while are
extremely rare in the early gastric cancer
(EGC) setting.
This case report deals with a gastric
metastasis from ductal breast cancer
in a 62 year-old woman, who had
previously undergone a left radical
mastectomy for a moderately
differentiated grade breast carcinoma
and adjuvant chemotherapy.
An endoscopic biopsy of
gastric neoplasm was
performed 14 years later,
as she reported
epigastralgia associated
with nausea.
A histologic evaluation
highlighted glandular elements
with a predominant tubular
growth pattern infiltrating the
lamina propria stroma.
The immunohistochemical
evaluation of which was ER-CK7
positive, and PR-CK20-CDX2
negative, confirming the gastric
metastasis from breast carcinoma.
Negative for neuroendocrine tumor:
S-100, Chromogranin A, and
Synaptophisin.
Therapeutic Decision
The patients was undergone six
courses of docetaxel-based
chemotherapy, reporting a radiologic
complete response.
Actually, she is taking hormonal
therapy with an aromatase inhibitor.
Conclusion:
gastrointestinal metastases from breast
carcinoma are rare; in the presence of a
carcinomatous gastric neoplasm in a patient
with a clinical history of invasive breast cancer,
we should suppose the probability of a
secondary gastric localization. the
histomorphological and immunohistochemical
evaluations are essential to make a correct
diagnosis and a consequent adequate
therapeutic protocol.
References:
1) B.G. Taal, H. Peterse, and H. Boot, “Clinical presentation, endoscopic
features, and treatment of gastric metastases from breast
carcinoma”, Cancer, vol. 89, N. 11, pp 2214-2221, 2000,
2) P.G. Chu and L.M. Weiss, “Immunohistochemical characterization of
sing-ring cell carcinomas of the stomach, breast and colon”, AJCP,
vol. 121, N. 6, pp 884-892, 2004;
3) Wan Kyu Eo, “Breast ancer metastasis to the stomach resembling
early gastric cancer”, Cancer Res Treat. 2008; 40(4): 207-210;
4) Titi M.A., Anabtawi A., and Newland A.D., “Isolated gastrointestinal
metastasis of the breast carcinoma: a case report”; HPC, case
reports in medicine, Vol. 2010, Ar. ID 615923;
5) Ambroggi M. and ot., “Metastatic breast cancer to the G.I. tract:
report of five cases and review of the literature”; HPC, IJ of Breast
Cancer, Vol. 2012, ID 439023.