Amberger Melissa, Presnick Nancy, Baltazar Gerard
Department of Surgery, SBH Health System, Bronx, NY, USA.
New York Institute of Technology College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA.
Case Rep Surg. 2018 Jun 13;2018:6085730. doi: 10.1155/2018/6085730. eCollection 2018.
Breast cancer metastasis to the gastrointestinal tract is rare and mostly limited to case reports which recommend consideration of metastasis when breast cancer patients particularly those with invasive lobular carcinoma present with new gastrointestinal complaints.
We report a 50-year-old female who presented with gastrointestinal symptoms of nausea and vomiting determined to be the result of large bowel obstruction secondary to rectosigmoid metastasis and carcinomatosis of breast invasive lobular carcinoma. She was treated with diverting loop sigmoid colostomy for her large bowel obstruction.
Our case reflects the importance of gastrointestinal surveillance of patients with a history of breast cancer. Current National Comprehensive Cancer Network (NCCN) guidelines for stage I-II breast cancer suggest posttreatment lab and imaging evaluation for metastasis only if new symptoms present.
We observed an unusually rapid disease progression, requiring evaluation of new gastrointestinal symptoms. Assessment for GI tract metastatic involvement should be done as early as progression to symptomatic disease can result in need for further invasive surgery in advanced stages of cancer.
乳腺癌转移至胃肠道较为罕见，大多仅限于病例报告，这些报告建议当乳腺癌患者，尤其是浸润性小叶癌患者出现新的胃肠道症状时，应考虑转移的可能性。
我们报告一例50岁女性，其出现恶心和呕吐的胃肠道症状，经诊断是由于直肠乙状结肠转移及乳腺浸润性小叶癌的癌性腹膜炎继发大肠梗阻所致。她因大肠梗阻接受了转流性乙状结肠造口术治疗。
我们的病例反映了对有乳腺癌病史患者进行胃肠道监测的重要性。当前美国国立综合癌症网络（NCCN）针对Ⅰ-Ⅱ期乳腺癌的指南建议，仅在出现新症状时才进行转移的治疗后实验室及影像学评估。
我们观察到疾病进展异常迅速，需要对新的胃肠道症状进行评估。对于胃肠道转移受累的评估应尽早进行，因为进展到有症状的疾病可能会导致在癌症晚期需要进一步的侵入性手术。
