A case of Laparoscopic-Assisted left Colectomy for Large Bowel Obstruction Caused by Peritoneal Breast Cancer Dissemination 22 Years after Total Mastectomy

Abstract

A 71-year-old woman who underwent radical mastectomy for left breast cancer at the age of 49 years presented with vomiting and abdominal pain. Abdominal contrast-enhanced CT showed large bowel obstruction of the descending colon around the splenic flexure caused by a tumor. Bone scintigraphy showed an increased uptake in the thoracolumbar region, pelvis, left clavicle, humeral head, and right 6th rib. Interval laparoscopic-assisted colectomy was performed after intestinal decompression. The histological findings of the resected specimen indicated an invasive lobular carcinoma. She was diagnosed with peritoneal dissemination and multiple bone metastases of breast cancer. Recurrence of peritoneal dissemination after resection of breast cancer rarely causes intestinal obstruction, and late recurrence of breast cancer after >20 years is also relatively rare. We report a rare case for which laparoscopy-assisted surgery was performed and review the literature on peritoneal dissemination and multiple bone metastases of breast cancer.