2025 Volume 45 Issue 7 Pages 623-626
Breast cancer rarely metastasizes to the small bowel, but metastases can occasionally lead to bowel obstruction or gastrointestinal perforation. We report a case of small bowel obstruction caused by multiple metastatic lesions in a patient with invasive lobular carcinoma of the breast. The patient was an 85-year-old woman with right breast cancer and multiple bone metastases who had been receiving chemotherapy and been subsequently transitioned to palliative care. She presented with persistent abdominal pain, and contrast-enhanced abdominal CT suggested strangulated small bowel obstruction, prompting emergency surgery. A neoplastic lesion serving as the point of obstruction was found in the terminal ileum, approximately 50 cm proximal to the ileocecal junction, and another lesion was identified more proximally. We performed partial resection of the small bowel, including both lesions. The findings of histopathological examination of the resected specimen, including the negative staining of the tumors for E-cadherin, confirmed the diagnosis of small bowel metastasis from invasive lobular carcinoma. Even in patients with end-stage breast cancer, persistent abdominal pain should raise the suspicion of gastrointestinal metastases, including those to the small bowel. Furthermore, when encountering obstruction caused by a metastatic small bowel tumor, the possibility of multiple lesions must be borne in mind.
