Abstract
We experienced a case of small bowel metastasis of breast cancer presented with intestinal obstruction which was surgically resected. The patient was in her seventies who had undergone right mastectomy for right breast cancer nine years earlier, of which histologic type was scirrhus carcinoma in Stage IIB (T2N1). This time the patient was admitted to the hospital because of ileus symptoms. Small bowel fluoroscopic study revealed narrowing of the ileum of unknown cause. On the seventh hospital day she underwent laparoscopy-assisted surgery. Operative findings included whole-circumferential thickening of the small bowel wall at the ileum about 1 m proximal to the Bauhin valve, and the thickening lesion was resected. Histopathology of the resected specimen showed that highly atypical tumor cells which appeared to be derived from the breast cancer had proliferated mainly in the subserous layer and reached to the mucosal surface. Immunohistochemistry revealed the tumor cells to be positive for ER, negative for PgR, and positive for Her/neu protein that were coincided with findings of the initially resected specimen. Accordingly intestinal obstruction due to small bowel metastasis of breast cancer was finally diagnosed. Her postoperative course was uneventful and she was discharged from the hospital on the 17th postoperative day. She, however, died of cancerous cachexia on the 83rd postoperative day.
Small bowel metastasis of breast cancer often occurs in its terminal stage and rarely becomes a candidate for surgical resection.
