Delungahawatta Thilini, Hum Richard, Woo Stephanie M, Samdani Rashmi, Real Mark J
Department of Internal Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA.
Georgetown University School of Medicine, Washington, D.C., USA.
Case Rep Gastrointest Med. 2025 May 3;2025:2763114. doi: 10.1155/crgm/2763114. eCollection 2025.
Metastases to the gastrointestinal tract from primary breast malignancies are rare. Acute gastrointestinal bleeding in patients with history of breast cancer, however, should raise clinical suspicion and warrant further investigation for metastatic disease involving the gastrointestinal tract. We report a case of a 74-year-old female with metastatic breast cancer and provoked thromboembolic events on anticoagulation, who was found to have poorly cohesive gastric carcinoma with immunohistochemistry consistent with primary breast malignancy, after presenting with new-onset melena. Use of anticoagulation may have exacerbated bleeding prompting endoscopic examination. Biopsy and histologic assessment are needed for definitive diagnosis and timely management.
原发性乳腺恶性肿瘤转移至胃肠道较为罕见。然而,有乳腺癌病史的患者出现急性胃肠道出血时,应引起临床怀疑,并需进一步检查是否存在累及胃肠道的转移性疾病。我们报告一例74岁女性转移性乳腺癌患者,在接受抗凝治疗时发生血栓栓塞事件,该患者在出现新发黑便后,被发现患有低黏附性胃癌,免疫组化结果与原发性乳腺恶性肿瘤一致。抗凝治疗可能加剧了出血,从而促使进行内镜检查。明确诊断和及时治疗需要活检和组织学评估。