Breast cancer metastasis from Gastric Carcinoma in a young female
More details
Hide details
Medical Oncologist, Department of Medical Oncology, Hiwa Cancer Hospital, Sulaymaniyah, Kurdistan Region, Iraq
Histopathologist, Department of Pathology Lab, Hiwa Cancer Hospital, Sulaymaniyah, Kurdistan Region, Iraq
Radiologist, Department of Radiology, Hiwa Cancer Hospital, Sulaymaniyah, Kurdistan Region, Iraq
MSPH, BPH, Research Department, General Directorate of Health, Sulaimani, Iraq
PhD, MSC, HDCM, BPH, & DCM, Department of family & Community Medicine, Collage of Medicine, University of Sulaimani. Sulaimani, Iraq
Online publication date: 2019-12-26
Publication date: 2019-12-26
Electron J Gen Med 2019;16(6):em181
Gastric cancer is a disease of elderly patients and mainly metastasis to liver, lung, and peritoneum, while signet ring cell is a variant of gastric cancer and commonly metastasis to peritoneum and lymph nodes. Metastasis to mammary is a rare condition which account for 3% and has poor prognosis. Generally extra mammary carcinoma precedes breast metastasis by 2 years. It’s uncommon to have breast metastasis as a first manifestation of extra mammary malignancies. There is no age limit and presentation my mimic primary breast cancer. Due to rarity of this condition there are no consensuses about clinical, radiological and histological features which make it a challenging task to distinguish primary from metastatic breast neoplasm. The case bellow is a young woman with diagnoses of diffuse-signet ring cell gastric cancer. First presentation was right breast edema with ascites, peritoneal nodules, and enlarged enhancing ovaries on imaging. Biopsy from each site confirmed involvement by metastatic adenocarcinoma with signet ring pattern. Her condition progressed after 5th cycle of EOX.
Ferlay J, Shin HR, Bray F. Estimate of worldwide burden of cancer in 2008: GOLOBOCAN 2008. International Journal of Cancer, 2010 December 15;127(12):2893-917. PMid:21351269.
Hyung WJ, Noh SH, Lee JH, et al. Early gastric carcinoma with signet ring cell histology. Cancer, 2002 January 1;94(1):78-83. PMid:11815962.
Maehara Y, Sakaguchi Y, Moriguchi S, et al. Signet ring cell carcinoma of the stomach. Cancer, 1992 April 1;67(7):1545-1650.<1645::AID-CNCR2820690702>3.0.CO;2-X.
Charalampakis N, Nogueras Gonzalez GM, Elimova E, et al. The Proportion of Signet Ring Cell Component in Patients with Localized Gastric Adenocarcinoma Correlates with the Degree of Response to Pre-Operative Chemoradiation. Oncology, 2016;90:239-47. PMid:27046280 PMCid:PMC4870109.
Henger U, Blank S, Weicha C, et al. Is Preoperative Chemotherapy Followed by Surgery the Appropriate Treatment for Signet Ring Cell Containing Adenocarcinomas of the Esophagogastric Junction and Stomach? Annals of Surgical Oncology, 2014 May;21(5):1739-48. PMid:24419755.
DeVita V, Lawrence S, Rosenberg A. Devita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. 10th ed. Vincent T. DeVita, TSLSAR, editor. Woltes Kluwer Health; 2015.
Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An Attempt at a Histo-Clinical Classification, 1965 September;16:150-4. PMid:14320675.
Casciato D, Territo M. Manual of Clinical Oncology. 7th ed. Philadelphia: Wolters Kluwe; 2012.
Abrams H, Spiro R, Goldstein N. Metastasis in carcinoma. Analysis of 1000 autopsied case. Cancer, 1950;3(1):74-85.<74::AID-CNCR2820030111>3.0.CO;2-7.
Otsuji E, Yamaguchi T, Sawai K, et al. Characterization of signet ring cell carcinoma of the stomach. Journal of Surgical Oncology, 1998 April;67(4):216-20.<216::AID-JSO2>3.0.CO;2-B.
Vergier B, Trojani M, De Mascarel I, et al. Metastases to the breast: Differential diagnosis from primary breast carcinoma. Journal of Surgical Oncology, 1991 October;48(2):119-6. PMid:1921396.
Toombs BD, Kalisher L. Metastatic disease to the breast: clinical, pathologic, and radiographic features. American Journal of Roentgenology, 1977 October;129(4):673-6.
McCrea ES, Johnston C, Haney PJ. Metastases to the breast. American Journal of Roentgenology, 1983;141(4):685-90. PMid:6604418.
Georgiannos SN, Aleong JC, Goode AW, et al. Secondary neoplasms of the breast. A survey of the 20th century. Cancer, 2001 November 1;92(9):2259-66.<2259::AID-CNCR1571>3.0.CO;2-O.
Alexander HR, Turnbull AD, Rosen PP. Isolated breast metastases from gastrointestinal carcinomas: Report of two cases. Journal of Surgical Oncology, 1989 December;42(4):264-6. PMid:2556613.
He CL, Chen P, Xia BL, et al. Breast metastasis of gastric signet-ring cell carcinoma: a case report and literature review. World Journal of Surgical Oncology, 2015 March 29;13(1):125. PMid:25890325 PMCid:PMC4386101.
Alva S, Shetty-Alva N. An Update of Tumor Metastasis to the Breast Data. Arch Surg., 1999;134(4):450. PMid:10199322.
Kwak JY, Kim EK, Oh KK. Radiologic findings of metastatic signet ring cell carcinoma to the breast from stomach. Yonsei Medical Journal, 2000;41(5):669-72. PMid:11079630.
Lee SK, Kim WW, Kim SH, et al. Characteristics of metastasis in the breast from extramammary malignancies. Journal of Surgical Oncology, 2010 February 1;101(2):137-40. PMid:20082359.
Iesato A, Oba T, Ono M, et al. Breast metastases of gastric signet-ring cell carcinoma: a report of two cases and review of the literature. OncoTargets and Therapy, 2018 December 29;8:91-7.
Hajdu SI, Urban JA. Cancers metastatic to the breast. Cancer, 1972;29(6):1691-6.<1691::AID-CNCR2820290637>3.0.CO;2-4.
Pemberton JH, Nagorney DM, Gilmore JC, et al. Bronchogenic Carcinoma in Patients Younger than 40 Years. Ann Thorac Surg., 1983 November;36(5):509-15.
Grabiec J, Owen DA. Carcinoma of the stomach in young persons, 1985 July 15;56(2):388-96.<388::AID-CNCR2820560231>3.0.CO;2-J.
Çil T, Altıntaş A, Paşa S, et al. Gastric ring cell carcinoma metastasis to the breast: Two case reports. Turkish Journal of Cancer, 2009;39(2):62-5.
Briest S, Horn LC, Haupt R, et al. Metastasizing Signet Ring Cell Carcinoma of the Stomach—Mimicking Bilateral Inflammatory Breast Cancer. Gynicologic Oncology, 1999 September;74(3):491-4. PMid:10479517.
Boutis AL, Andreadis C, Patakiouta F, et al. Gastric signet-ring adenocarcinoma presenting with breast metastasis. World Journal of Gastroenterology, 2006 May 14;12(18):2958-61. PMid:16718828 PMCid:PMC4087820.
Qureshi SS, Shrikhande SV, Tanuja S, et al. Breast metastases of gastric signet ring cell carcinoma: A differential diagnosis with primary breast signet ring cell carcinoma. J Postgrad Med., 2005;51(2):125-7.
Paulus DD, Libshitz HI. Metastasis to the breast. Radiol Clin North Am., 1982 September;20(3):561-8.
Raptis S, Kanbour AI, Dusenbery D, et al. Fine-needle aspiration cytology of metastatic ovarian carcinoma to the breast, 1996 July;15(1):1-6.<1::AID-DC2>3.0.CO;2-N.
Azzopardi JG. Problems in breast pathology. Major problems in pathology Philadelphia: WB Saunders; 1979.
Silverberg SG, Masood S. Principle and Practice of surgicalpathology and cytopathology. 3rd ed. Silverberg SG, editor. New York: Churchill Livingstone; 1996.
Vergier B, Trojani M, Mascarel ID, et al. Metastases to the breast: Differential diagnosis from primary breast carcinoma, 1991 October;48(2):112-6. PMid:1921396.
Howarth CB, Caces JN, Pratt CB. Breast metastases in children with rhabdomyosarcoma. Cancer, 1980 December 1;46(11):2520-4.<2520::AID-CNCR2820461134>3.0.CO;2-H.
Raju U, Ma C, Shaw A. Signet ring variant of lobular carcinoma of the breast: a clinicopathologic and immunohistochemical study. Europe PMC, 1993 September 1;6(5):516-20.
Tot T. The role of cytokeratins 20 and 7 and estrogen receptor analysis in separation of metastatic lobular carcinoma of the breast and metastatic signet ring cell carcinoma of the gastrointestinal tract, 2000 January;106(8):467-72. PMid:11028811.
Martinez V, Azzopardi JG. Invasive lobular carcinoma of the breast: incidence and variants. Histopathology, 1979 November;3(6):467-88. PMid:229072.
Merino MJ, Livolsi VA. Signet Ring Carcinoma of the Female Breast: A Clinicopathologic Analysis of 24 Cases. Cancer, 1981 October 15;48(8):8030-7.<1830::AID-CNCR2820480821>3.0.CO;2-H.
Cavazzini G, Colpani F, Cantore M, et al. Breast metastasis from gastric signet ring cell carcinoma, mimicking inflammatory carcinoma. Europe PMC, 1993 December;79(6):450-3. PMid:8171750.
An Update of Tumor Metastasis to the Breast Data. Arch Surg., 1999 April;134(4):450. PMid:10199322.
Journals System - logo
Scroll to top