Kioleoglou Zacharoula, Georgaki Eleni, Koufopoulos Nektarios, Kostek Osman, Volakakis Nikolaos, Dimitriadou Areti, Kokkali Stefania
Department of Surgery, Metaxa Cancer Hospital, Piraeus, CYP.
Second Department of Medicine, Medical School, Hippocratio General Hospital of Athens, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2024 Jul 31;16(7):e65852. doi: 10.7759/cureus.65852. eCollection 2024 Jul.
Invasive lobular carcinoma (ILC) represents a rare subtype of breast carcinoma, originating from the lobule. Unlike ductal carcinoma, ILC does not express E-cadherin and thus can metastasize to uncommon sites. We aimed to investigate the clinicopathological characteristics of the rare subgroup of ILC patients with gastrointestinal (GI) metastases. A PubMed search was undertaken using the terms "Lobular Breast Carcinoma" AND "Gastrointestinal Metastasis." We identified 169 cases, with metachronous GI metastatic disease being approximately twice as common as synchronous GI metastases. The median age at initial diagnosis was 56.7 years (24-88). The majority of patients were hormonal receptor-positive and only a small minority was HER2-positive. The appearance of a gastrointestinal lesion was often the mode of revelation of ILC. Differential diagnosis from primary gastrointestinal cancer is sometimes challenging, especially in the case of signet-ring cell carcinoma. The median time from breast cancer diagnosis to GI metastases was 6.5 years (0-33). Most common metastatic sites include the stomach, colon, and rectum, in order of decreasing frequency, whereas metastases were found in every part of the digestive tract. In conclusion, metastases of ILC can arise in the gastrointestinal tract and they should be managed similarly to metastatic breast cancer.
浸润性小叶癌（ILC）是一种罕见的乳腺癌亚型，起源于小叶。与导管癌不同，ILC不表达E-钙黏蛋白，因此可转移至不常见的部位。我们旨在研究发生胃肠道（GI）转移的罕见ILC患者亚组的临床病理特征。使用“小叶性乳腺癌”和“胃肠道转移”这两个术语在PubMed上进行检索。我们共识别出169例病例，异时性GI转移疾病的发生率约为同时性GI转移的两倍。初次诊断时的中位年龄为56.7岁（24 - 88岁）。大多数患者激素受体呈阳性，只有一小部分HER2呈阳性。胃肠道病变的出现常常是ILC的发现方式。与原发性胃肠道癌进行鉴别诊断有时具有挑战性，尤其是在印戒细胞癌的情况下。从乳腺癌诊断到发生GI转移的中位时间为6.5年（0 - 33年）。最常见的转移部位依次为胃、结肠和直肠，而在消化道的各个部位均发现有转移。总之，ILC可发生胃肠道转移，对其处理应与转移性乳腺癌类似。
