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Invasive lobular carcinoma of breast with synchronous colon metastasis
Zhu-Jun Loh1, Kuo-Ting Lee1, Wei-Pang Chung2, Wen-Chung Chen3, Hsueh-Li Kuo4, Po-Jun Chen2, Hsi-Huei Lu5, Hui-Ping Hsu1
1 Department of Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
2 Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
3 Department of Pathology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
4 Department of Radiology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
5 Department of Nuclear Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
Correspondence Address:
Hui-Ping Hsu
No. 138, Sheng Li Rd., Tainan City 704
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/fjs.fjs_22_17
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Secondary colon malignancy is rare and has a nonspecific presentation. Breast cancer is the second most common malignancy that metastasizes to the gastrointestinal (GI) tract. Here, we present the case of a 54-year-old woman diagnosed with breast cancer and synchronous colon metastasis through a positive result obtained from stool occult blood screening. Colonoscopy revealed a subepithelial tumor of the colon. Biopsy revealed metastatic cancer with positive cytokeratin and GATA-binding protein 3 staining, as well as negative caudal-type homeobox 2 staining. A palpable right breast mass with nipple retraction was found, and invasive lobular carcinoma (ILC) was diagnosed. Multiple bone, left adrenal gland, para-aortic lymph node, and contralateral breast metastases were detected. Multimodality treatment involving systemic chemotherapy, hormone therapy, and modified radical mastectomy was applied. In our clinical experience, colon metastasis from breast cancer is rare and usually mimics primary colon cancer. High-alert speculation and aggressive biopsy for patients with abnormal GI bleeding are indicated for diagnosis. Patients with colon metastasis from ILC of the breast have a poor prognosis. Therefore, multimodality treatments should be applied to improve their prognosis. |
