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Case report
Breast carcinoma metastasising to the gastric wall and the peritoneum: what physicians need to know
  1. Abdullah Sohail1,
  2. Ahmad Khan1,
  3. Alexander Gross2 and
  4. Hamza Shah3
  1. 1West Virginia University Robert C Byrd Health Sciences Center Charleston Division, Charleston, West Virginia, USA
  2. 2Pathology Resident, West Virginia University—Health Sciences Campus, Morgantown, West Virginia, USA
  3. 3Assistant Professor Gastroenterology, Charleston Area Medical Center, Charleston, West Virginia, USA
  1. Correspondence to Dr Abdullah Sohail; abdullahsohailmd{at}gmail.com

Abstract

Breast cancer is the most common cancer among women in the USA and rarely metastasises to the gastric wall. We present a case of a 69-year-old woman with medical history of stage II-B breast cancer who presented with epigastric abdominal pain and black tarry stools. CT scan of the abdomen showed moderate gastric wall thickening and ascites. The patient underwent an esophagogastroduodenoscopy (EGD) with endoscopic ultrasound (EUS) for a fine-needle biopsy, which was negative for malignancy. Based on her presentation, we kept a high index of suspicion for peritoneal carcinomatosis and malignancy. The patient underwent laparoscopic wedge resection of the gastric wall with biopsies of gastric wall and peritoneum. Both biopsies confirmed the diagnosis of metastatic invasive lobular breast carcinoma. Our case highlights the importance of diagnostic laparoscopy and EUS in the setting of negative EGD biopsy results with a high suspicion of breast cancer metastasis to gastric wall.

  • breast cancer
  • gastric cancer
  • stomach and duodenum

http://dx.doi.org/10.1136/bcr-2020-241467

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    Footnotes

    • Contributors AS wrote the manuscript and is the article corresponding author. AK wrote and revised the manuscript. AG helped with pathology images and description. HS revised the manuscript and gave the final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.