Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2015

Open Access 01-12-2015 | Case report

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

Authors: Tadatoshi Osaku, Hideaki Ogata, Shunsuke Magoshi, Yorichika Kubota, Fumi Saito, Shinsaku Kanazawa, Hironori Kaneko

Published in: Journal of Medical Case Reports | Issue 1/2015

Login to get access

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.
Literature
1.
go back to reference Harris M, Howell A, Chrissohou M, Swindell RI, Hudson M, Sellwood RA. A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast. Br J Cancer. 1984;50:23–30.CrossRefPubMedPubMedCentral Harris M, Howell A, Chrissohou M, Swindell RI, Hudson M, Sellwood RA. A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast. Br J Cancer. 1984;50:23–30.CrossRefPubMedPubMedCentral
2.
go back to reference McLemore EC, Pockaj BA, Reynolds C, Gray RJ, Hernandez JL, Grant CS, et al. Breast cancer: presentation and intervention in women with gastrointestinal metastasis and carcinomatosis. Ann Surg Oncol. 2005;12:886–94. doi:10.1245/ASO.2005.03.030.CrossRefPubMed McLemore EC, Pockaj BA, Reynolds C, Gray RJ, Hernandez JL, Grant CS, et al. Breast cancer: presentation and intervention in women with gastrointestinal metastasis and carcinomatosis. Ann Surg Oncol. 2005;12:886–94. doi:10.1245/ASO.2005.03.030.CrossRefPubMed
3.
go back to reference Sobinsky JD, Willson TD, Podbielski FJ, Connolly MM. Unusual metastatic patterns of invasive lobular carcinoma of the breast. Case Rep Oncol Med. 2013;2013:986517. Epub 2013 Nov 10. doi:10.1155/2013/986517.PubMedPubMedCentral Sobinsky JD, Willson TD, Podbielski FJ, Connolly MM. Unusual metastatic patterns of invasive lobular carcinoma of the breast. Case Rep Oncol Med. 2013;2013:986517. Epub 2013 Nov 10. doi:10.1155/2013/986517.PubMedPubMedCentral
4.
go back to reference Saranovic D, Kovac JD, Knezevic S, Susnjar S, Stefanovic AD, Saranovic DS, et al. Invasive lobular breast cancer presenting an unusual metastatic pattern in the form of peritoneal and rectal metastases: a case report. J Breast Cancer. 2011;14:247–50. doi:10.4048/jbc.2011.14.3.247.CrossRefPubMedPubMedCentral Saranovic D, Kovac JD, Knezevic S, Susnjar S, Stefanovic AD, Saranovic DS, et al. Invasive lobular breast cancer presenting an unusual metastatic pattern in the form of peritoneal and rectal metastases: a case report. J Breast Cancer. 2011;14:247–50. doi:10.4048/jbc.2011.14.3.247.CrossRefPubMedPubMedCentral
5.
go back to reference Arrangoiz R, Papavasiliou P, Dushkin H, Farma JM. Case report and literature review: Metastatic lobular carcinoma of the breast an unusual presentation. Int J Surg Case Rep. 2011;2:301–5. Epub 2011 Oct 12. doi:10.1016/j.ijscr.2011.06.010.CrossRefPubMedPubMedCentral Arrangoiz R, Papavasiliou P, Dushkin H, Farma JM. Case report and literature review: Metastatic lobular carcinoma of the breast an unusual presentation. Int J Surg Case Rep. 2011;2:301–5. Epub 2011 Oct 12. doi:10.1016/j.ijscr.2011.06.010.CrossRefPubMedPubMedCentral
6.
go back to reference Yousef GM, Gabril MY, Al-Haddad S, Mulligan AM, Honey RJ. Invasive lobular carcinoma of the breast presenting as retroperitoneal fibrosis: a case report. J Med Case Rep. 2010;4:175. doi:10.1186/1752-1947-4-175.CrossRefPubMedPubMedCentral Yousef GM, Gabril MY, Al-Haddad S, Mulligan AM, Honey RJ. Invasive lobular carcinoma of the breast presenting as retroperitoneal fibrosis: a case report. J Med Case Rep. 2010;4:175. doi:10.1186/1752-1947-4-175.CrossRefPubMedPubMedCentral
7.
go back to reference Franceschini G, Manno A, Mulè A, Verbo A, Rizzo G, Sermoneta D, et al. Gastro-intestinal symptoms as clinical manifestation of peritoneal and retroperitoneal spread of an invasive lobular breast cancer: report of a case and review of the literature. BMC Cancer. 2006;6:193. doi:10.1186/1471-2407-6-193.CrossRefPubMedPubMedCentral Franceschini G, Manno A, Mulè A, Verbo A, Rizzo G, Sermoneta D, et al. Gastro-intestinal symptoms as clinical manifestation of peritoneal and retroperitoneal spread of an invasive lobular breast cancer: report of a case and review of the literature. BMC Cancer. 2006;6:193. doi:10.1186/1471-2407-6-193.CrossRefPubMedPubMedCentral
8.
go back to reference Nikkar-Esfahani A, Kumar BG, Aitken D, Wilson RG. Metastatic breast carcinoma presenting as a sigmoid stricture: report of a case and review of the literature. Case Rep Gastroenterol. 2013;7:106–11. doi:10.1159/000348760.CrossRefPubMedPubMedCentral Nikkar-Esfahani A, Kumar BG, Aitken D, Wilson RG. Metastatic breast carcinoma presenting as a sigmoid stricture: report of a case and review of the literature. Case Rep Gastroenterol. 2013;7:106–11. doi:10.1159/000348760.CrossRefPubMedPubMedCentral
9.
go back to reference Ciulla A, Castronovo G, Tomasello G, Maiorana AM, Russo L, Daniele E, et al. Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems. World J Surg Oncol. 2008;6:78. doi:10.1186/1477-7819-6-78.CrossRefPubMedPubMedCentral Ciulla A, Castronovo G, Tomasello G, Maiorana AM, Russo L, Daniele E, et al. Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems. World J Surg Oncol. 2008;6:78. doi:10.1186/1477-7819-6-78.CrossRefPubMedPubMedCentral
10.
go back to reference Razzetta F, Tassara E, Saro F, Sironi M, D’Ambrosio G. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg. 2011;63(2):129–33. doi:10.1007/s13304-011-0047-x.CrossRefPubMed Razzetta F, Tassara E, Saro F, Sironi M, D’Ambrosio G. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg. 2011;63(2):129–33. doi:10.1007/s13304-011-0047-x.CrossRefPubMed
11.
go back to reference Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:R149–56. doi:10.1186/bcr767.CrossRefPubMedPubMedCentral Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:R149–56. doi:10.1186/bcr767.CrossRefPubMedPubMedCentral
12.
go back to reference Gamallo C, Palacios J, Suarez A, Pizarro A, Navarro P, Quintanilla M, et al. Correlation of E-cadherin expression with differentiation grade and histological type in breast carcinoma. Am J Pathol. 1993;142:987–93.PubMedPubMedCentral Gamallo C, Palacios J, Suarez A, Pizarro A, Navarro P, Quintanilla M, et al. Correlation of E-cadherin expression with differentiation grade and histological type in breast carcinoma. Am J Pathol. 1993;142:987–93.PubMedPubMedCentral
13.
go back to reference Korhonen T, Huhtala H, Holli K. A comparison of the biological and clinical features of invasive lobular and ductal carcinomas of the breast. Breast Cancer Res Treat. 2004;85:23–9.CrossRefPubMed Korhonen T, Huhtala H, Holli K. A comparison of the biological and clinical features of invasive lobular and ductal carcinomas of the breast. Breast Cancer Res Treat. 2004;85:23–9.CrossRefPubMed
14.
go back to reference Pai K, Baliga P, Shrestha BL. E-cadherin expression: a diagnostic utility for differentiating breast carcinomas with ductal and lobular morphologies. J Clin Diagn Res. 2013;7:840–4. Epub 2013 Mar 18. doi:10.7860/JCDR/2013/5755.2954.PubMedPubMedCentral Pai K, Baliga P, Shrestha BL. E-cadherin expression: a diagnostic utility for differentiating breast carcinomas with ductal and lobular morphologies. J Clin Diagn Res. 2013;7:840–4. Epub 2013 Mar 18. doi:10.7860/JCDR/2013/5755.2954.PubMedPubMedCentral
15.
go back to reference Fernandes GS, Corrêa TS, Carvalho EP, Katz A, Hoff PM. Gastric and endobronchial metastases in a case of lobular breast cancer. Case Rep Oncol. 2013;6:555–60.CrossRefPubMedPubMedCentral Fernandes GS, Corrêa TS, Carvalho EP, Katz A, Hoff PM. Gastric and endobronchial metastases in a case of lobular breast cancer. Case Rep Oncol. 2013;6:555–60.CrossRefPubMedPubMedCentral
16.
go back to reference Gallamini A, Zwarthoed C, Borra A. Positron Emission Tomography (PET) in oncology. Cancers (Basel). 2014;6(4):1821–89. doi:10.3390/cancers6041821.CrossRef Gallamini A, Zwarthoed C, Borra A. Positron Emission Tomography (PET) in oncology. Cancers (Basel). 2014;6(4):1821–89. doi:10.3390/cancers6041821.CrossRef
Metadata
Title
Metastatic nonpalpable invasive lobular breast carcinoma presenting as rectal stenosis: a case report
Authors
Tadatoshi Osaku
Hideaki Ogata
Shunsuke Magoshi
Yorichika Kubota
Fumi Saito
Shinsaku Kanazawa
Hironori Kaneko
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-015-0568-x

Other articles of this Issue 1/2015

Journal of Medical Case Reports 1/2015 Go to the issue