Esophageal Perforation in a Patient With Metastatic Breast Cancer to Esophagus

ArticleinThe Annals of thoracic surgery 81(3):1136-8 · April 2006with16 Reads
DOI: 10.1016/j.athoracsur.2005.01.052 · Source: PubMed
Esophageal metastasis from breast cancer is rare and can present after a long latency period. The middle and distal third of the esophagus are the most common sites and dysphagia (with or without stricture) is the most common presentation. Because of predominantly submucosal involvement, diagnosis is often difficult to establish until significant complications arise. We present the case of a patient with esophageal perforation due to dilatation treatments for dysphagia secondary to a distal stricture, later proven to be caused by esophageal metastasis from a breast cancer treated 19 years earlier.
    • "By contrast, three patients died postoperatively, suggesting the highly invasive nature of surgical therapy when adapted to esophageal lesions [22]. The remaining patients were treated with dilatation, stenting and/or radiation in 13, three and six cases, respectively5678910111213141516171819 . Only shortterm follow-up results are available for patients who underwent dilatation and stenting (9). "
    [Show abstract] [Hide abstract] ABSTRACT: Cases of esophageal metastasis of breast cancer are extremely rare. We present the case of a patient who developed recurrence as esophageal metastasis following treatment of bilateral breast cancer. Early-stage gastric cancer was also found coincidentally. An 86-year-old Japanese female patient with a history of bilateral breast cancer was found to have a gastric mass on a medical examination. At 72 years of age, she had undergone a total mastectomy with level II axillary lymph node dissection (pT3N0M0 stage II). Left breast cancer was found at the age of 79. A total mastectomy was performed with level II axillary lymph node dissection (pT1N0M0 stage I). At the time of her current admission, our patient complained of dysphagia. A repeat gastrofiberscopy revealed a submucosal lesion in her middle esophagus, located 27cm distal to her incisors, as well as a known type I tumor of the gastric cardia. Computed tomography showed a mass lesion in her middle esophagus that had grown extraluminally and infiltrated the tracheal bifurcation and her left primary bronchus. A boring biopsy of the esophageal lesion was performed under ultrasonic monitoring, and a pathological diagnosis of poorly differentiated adenocarcinoma of the esophagus was obtained. The biopsy of the cardiac lesion revealed moderately differentiated adenocarcinoma of the stomach. The expression status of her hormone receptors indicated that the esophageal lesion reflected metastatic recurrence of her breast cancer with coincidental primary gastric cancer (cT1N0M0 stage IA). Esophageal metastasis of breast cancer is extremely rare. An individualized treatment plan combining multimodal approaches should therefore be devised according to the patient's status.
    Full-text · Article · Feb 2014
    • "There have been interesting case reports in literature, of metastatic breast cancer presenting with bowel perforation in patients receiving chemotherapy [18,19] as well as those not receiving chemotherapy [20]. Daniel A et al [21] have reported a case of oesophageal perforation in a patient with oesophageal metastasis from breast. Careful evaluation of gastrointestinal tract in patients with advanced breast cancer receiving chemotherapy may prevent intestinal perforation [19]. "
    [Show abstract] [Hide abstract] ABSTRACT: Gastrointestinal metastsasis from the breast cancer are rare. We report a patient who presented with intestinal obstruction due to solitary caecal metastasis from infiltrating ductal carcinoma of breast. We also review the available literature briefly. A 72 year old lady with past history of breast cancer presented with intestinal obstruction due to a caecal mass. She underwent an emergency right hemicolectomy. The histological examination of the right hemicolectomy specimen revealed an adenocarcinoma in caecum staining positive for Cytokeratin 7 and Carcinoembryonic antigen and negative for Cytokeratin 20, CDX2 and Estrogen receptor. Eight out of 11 mesenteric nodes showed tumour deposits. A histological diagnosis of metastatic breast carcinoma was given. To the best of our knowledge, this is the first case report of solitary metastasis to caecum from infiltrating ductal carcinoma of breast. Awareness of this possibility will aid in appropriate management of such patients.
    Full-text · Article · Feb 2008
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