Dados do Resumo

Título

Metastatic Colon Cancer from Ductal Breast Carcinoma: Diagnostic Challenges

Introdução

In 2022, 2.3 million women were diagnosed with breast cancer, with 670,000 global deaths. Even after prolonged remission, there is a risk of distant metastases. Common metastatic sites include regional lymph nodes, liver, bone, and brain, while the gastrointestinal tract is a rare site. Differentiating between primary colon tumors and metastatic disease presents a challenge for medical teams.

Objetivo

This study reports a case of metastatic breast cancer to the ascending colon and reviews literature highlighting the diagnostic difficulties in gastrointestinal metastases from breast cancer.

Métodos

A 73-year-old female, hypertensive, with a history of conization in 2007, presented with lower back pain and hematochezia. Diagnostic tests suggested secondary lesions: a bone scan showed lytic lesions in the lumbar spine, and colonoscopy revealed a lesion in the transverse colon, consistent with poorly differentiated carcinoma. A right colectomy was performed, revealing a 2 cm lesion in the ascending colon and metastasis in 1 of 17 lymph nodes, consistent with metastatic breast carcinoma.

Resultados

Gastrointestinal metastases from breast cancer often present with nonspecific symptoms like abdominal pain and weight loss, complicating differentiation from primary GI malignancies. Although gastrointestinal involvement is rare, lobular carcinoma is more likely to metastasize to the GI tract than ductal carcinoma. Treatment for primary GI cancers involves surgical resection, while metastatic breast cancer is typically managed with systemic chemotherapy and/or hormonal therapy. Primary resection of metastases does not improve survival and may be used palliatively. Median survival from recurrence is 12 to 16 months.

Conclusões

Despite extensive data and established treatments for breast and colon cancers, the oncological behavior and management of these tumors, particularly colorectal metastasis from primary breast cancer, present ongoing diagnostic challenges.