Gastric Metastasis Mimicking Early Gastric Cancer from Invasive Ductal Carcinoma of the Breast: Case Report and Literature Review

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 6; p. 980
• Main Authors: Yoo, Kwon Cheol, Kim, Dae Hoon, Park, Sungmin, Yun, HyoYung, Ryu, Dong Hee, Lee, Jisun, Son, Seung-Myoung
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-06-2024; MDPI
• Subjects: Aged; Biopsy; Breast cancer; Breast Neoplasms - pathology; Canada; Cancer therapies; Carcinoma, Ductal, Breast - diagnosis; Carcinoma, Ductal, Breast - secondary; Case Report; Chemotherapy; Colorectal cancer; Cytokeratin; cytokeratin 7; Diagnosis, Differential; Endoscopy; Female; Gastrectomy - methods; Gastric cancer; gastric metastasis; Gastrointestinal surgery; Health aspects; Humans; immunohistochemistry; invasive ductal carcinoma of breast; Laparoscopy; Lymphatic Metastasis; Lymphatic system; Medical prognosis; Metastasis; Mortality; Radiation; South Korea; Stomach cancer; Stomach Neoplasms - diagnosis; Stomach Neoplasms - pathology; Thyroid cancer; Ultrasonic imaging; Canada; South Korea; cytokeratin 7; immunohistochemistry; invasive ductal carcinoma of breast; gastric metastasis
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60060980

: Gastric metastasis from invasive ductal breast cancer (BC) is rare. It mainly occurs in patients with lobular BC. The occurrence of multiple metastases is typically observed several years after the primary diagnosis. Endoscopic findings of gastric metastasis of the BC were usually the linitis plastic type.
: A 72-year-old women who underwent right modified radical mastectomy (MRM) 10 month ago was referred after being diagnosed with early gastric cancer (EGC) during systemic chemotherapy. EGC type I was found at gastric fundus, and pathologic finding showed poorly differentiated adenocarcinoma. Metachronous double primary tumor EGC was considered.
: A laparoscopic total gastrectomy was performed, and postoperative pathology revealed submucosa invasion and two lymph node metastases. A pathologic review that focused on immunohistochemical studies of selected antibodies such as GATA binding protein 3 (GATA3), gross cystic disease fluid protein-15 (GCDFP-15), cytokeratin 7 (CK7) was performed again, comparing previous results. As a result, gastric metastasis from BC was diagnosed. After totally laparoscopic total gastrectomy, palliative first-line chemotherapy with paclitaxel/CDDP was performed. Two months after gastrectomy, she was diagnosed with para-aortic lymph node metastasis and multiple bone metastases. She expired six months after gastrectomy.
: Gastric metastasis from invasive ductal carcinoma of the breast, which is clinically manifested as EGC, is a very rare condition. If there is a history of BC, careful pathological review will be required.