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Il Giornale di Chirurgia

Metastatizzazione al colon discendente da carcinoma lobulare della mammella misconosciuto condizionante occlusione intestinale

Articolo, 6 - 8
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Distant spread from lobular breast cancer is common, but metastatic bowel involvement is unusual. We report a case of a 83 year old woman admitted with abdominal pain, ascites and fiver. Her history present only a right breast nodule yet biopsied with negative result for malignancy. Blood samples showed leucocitosis and radiological study with abdominal CT revealed only ascites. The paracentesis with cultural and cytological exam were negative. Support and antimicrobal therapy were started. After ten days the patient get worst, so explorative laparoscopy was performed. The retro-peritoneum and the left colon were find involved in a neopalstic mass. Laparotomical resection of involved bowel and definitive colostomy was performed in order to allow canalisation.
Intraoperative histological examination revealed retroperitoneal and bowel involvement from lobular breast cancer.
Than a surgical biopsy of r the right breast lesion was performed in operating theatre. To our knowledge this is one of few cases reported in literature of colon metastasis from lobular breast cancer. As like as others, metastatic involvement began in parastromal tissue and than infiltration gained sub-mucosal and mucosal tissue. So patient didn’t deveplops signs or symptoms of endoluminal masses or bowel occlusion.
No therapy could be started for severe pronstration and the patient died after 39 days from hospital admittance.

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