A CASE OF GASTRIC AND RETROPERITONEAL LYMPH NODES METASTASES AFTER MASTECTOMY

Abstract

The metastasis of breast cancer to the gastrointestinal organ is not so uncommon in autopsy cases, but we rarely encounter such a case clinically. This paper describes a rare case of gastric and retroperitoneal lymph nodes metastases after radical mastectomy.
A 53-year-old woman developed sense of thirst 2 years and 11 months after a standard radical mastectomy for a left breast cancer (t2n2m0 stage III). Radiological and endoscopic examination of the stomach showed a IIa+IIc like lesion and biopsy specimen obtained from the lesion revealed signet ring cell carcinoma. Under a diagnosis of early gastric cancer, laparotomy was performed, and proved to paraaortic and mesenteic lymph nodes metastases. Radical resection was impossible and gastrectomy was performed. Histological examination showed the tumor mass diffusely invading the submucosal layer but not the mucosal layer, which was almost similar to that of the breast cancer. These findings demonstrated that the gastric tumor resulted from the previously treated breast cancer. Thus, when the patient with previous history of breast cancer has gastrointestinal symptoms, we should consider a possibility of gastrointestinal metastasis from the breast cancer.