A case of breast cancer with rectal metastasis

Abstract

A 71-year-old woman who had undergone left breast-conserving surgery in 2003 was introduced to our hospital because of local recurrence and lymph node metastasis in April 2008. Combination therapy with capecitabine and docetaxel was started in the middle of May. In June, she was admitted to the hospital because of melena. Colonoscopy revealed an extensive ulcerated lesion in the rectal mucosa. We suspected drug induced rectal ulcer and changed to FEC 100 therapy after symptomatic remission was gained with conservative treatment. In September she was re-admitted to the hospital because of constipation and anal pain. Colonoscopy showed stenosis of the lumen of the rectum, but there were not malignant lesions. Because the symptoms due to stenosis were not improved, colostomy was made in October. Operative findings revealed absence of peritoneal metastases, but thickening of the rectal wall was observed. A transanal needle biopsy detected metastasis from breast cancer. Our report is of the 10^th case of rectal metastasis of breast cancer in the Japanese literature. We must bear in mind that rectal stenosis in a patient with a history of breast cancer can be metastasis of breast cancer. Further development of adjvant chemo therapy might diversify relapse sites from the disease.