A case of ileus associated with recurrent peritoneal dissemination and metastasis to the gastrointestinal tract of breast cancer

Abstract

A 56-year-old woman visited our emergency department because of abdominal bloating. She had a history of undergoing surgery for left breast cancer at the age of 42. On physical examination, only abdominal distension and mild tenderness were noted. An abdominal plain X-ray revealed ileus, and an abdominal CT scan revealed intestinal obstruction starting from the sigmoid colon. Lower gastrointestinal endoscopy showed a whole-circumferential stenosis of the sigmoid colon, but no evidence of tumorous lesion was present on the mucosal surface. Operative findings showed numerous white nodules in the abdominal cavity, and peritoneal dissemination was thus diagnosed. The stenosis of the sigmoid colon was confined within a markedly narrow segment. Granular white nodules were visible macroscopically in the enlarged ovaries bilaterally. Hartmann's operation and resection of the tumor of the left ovary were conducted.
Histopathologically, metastasis of the previous breast cancer was present in the muscular layer of the sigmoid colon. This paper presents this case of ileus associated with recurrent peritoneal dissemination and metastasis to the gastrointestinal tract of breast cancer, together with discussion of the literature.