Invasive Lobular Carcinoma of the Breast with Wide Spread Intestinal Metastases

Teruo Iwata, Masaru Morita, Shoji Nakata, Masakazu Sugaya, Kenji Ono, Takeshi Hanagiri, Kenji Sugio, Kosei Yasumoto, Sosuke Yamada* and Tetsuo Hamada**

Second Department of Surgery and Department of Pathology and Cell Biology*, University of Occupational and Environmental Health
Department of Surgical Pathology, Kyushu Rosai Hospital**

A 50-year-old woman came to our hospital with chief complaints of constipation and abdominal pain in the right lower quadrant 7 years after bilateral mastectomy for invasive lobular carcinoma. Both radiological and endoscopic examinations revealed multiple stenotic lesions in the colon and erosive lesions in the stomach. Poorly differentiated adenocarcinoma with signet-ring cells was detected in the biopsy specimens of the gastric lesions, and the biopsy of the colon tumor showed similar features. Since immunohistochemical studies for hormone receptors (estrogen receptor, Hercep test) were positive, the lesions were diagnosed as metastases of the breast cancer, and right hemicolectomy was performed. Histological examination revealed that the tumor cells in the colon had spread into the submucosal layer and serosa and were histologically similar to the breast cancer cells. Invasive lobular carcinoma of the breast tends to metastasize to the gastrointestinal tract. It is important to pay special attention to gastrointestinal tract metastases in patients with invasive lobular carcinoma of the breast. It is also important to consider the possibility of metastasis by invasive lobular carcinoma of the breast whenever signet-ring cell carcinoma of the gastrointestinal tract is encountered.

Key words
gastrointestinal metastasis, breast cancer, invasive lobular carcinoma

Reprint requests
Teruo Iwata Second Department of Surgery, University of Occupational of Environmental Health
1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu, 807-8555 JAPAN

Accepted
February 23, 2005

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