Rafizadeh Amirpasha, Yang Tze Wei Wilson, Nazaretian Simon, Chen Richard
Department of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC 3800, Australia.
Department of Oesophago-Gastric and Bariatric Surgery, Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia.
J Surg Case Rep. 2025 Jun 6;2025(6):rjaf387. doi: 10.1093/jscr/rjaf387. eCollection 2025 Jun.
Breast cancer remains a predominant contributor to cancer-related morbidity and mortality among women worldwide. Invasive lobular carcinoma (ILC), the second most prevalent histological subtype, exhibits a distinctive propensity for diffuse infiltration and distant metastases, including rare involvement of the gastrointestinal tract. We describe a case of acute gastric perforation secondary to metastatic ILC in a 67-year-old woman with recurrent Luminal A disease. Her prior treatment included wide local excision, adjuvant chemoradiotherapy, and salvage mastectomy. Emergent imaging revealed gastric perforation with diffuse intraperitoneal fluid. Following multidisciplinary discussion and in accordance with the patient's wishes, an R1 total gastrectomy was performed with palliative intent. The patient recovered well, despite a minor duodenal stump leak managed conservatively. She was subsequently discharged for ongoing oncological management. To our knowledge, this is the first reported case of emergency total gastrectomy for ILC-related gastric perforation, highlighting the potential role of aggressive surgical intervention in select individualized metastatic presentations.
乳腺癌仍然是全球女性癌症相关发病率和死亡率的主要贡献因素。浸润性小叶癌（ILC）是第二常见的组织学亚型，具有独特的弥漫性浸润和远处转移倾向，包括罕见的胃肠道受累。我们描述了一例67岁复发性Luminal A型疾病女性患者，因转移性ILC继发急性胃穿孔的病例。她之前的治疗包括广泛局部切除、辅助放化疗和挽救性乳房切除术。急诊影像学检查显示胃穿孔伴弥漫性腹腔积液。经过多学科讨论并根据患者意愿，为缓解症状进行了R1全胃切除术。尽管十二指肠残端有轻微渗漏，经保守治疗后患者恢复良好。随后她出院继续接受肿瘤治疗。据我们所知，这是首例因ILC相关胃穿孔行急诊全胃切除术的报道病例，凸显了积极手术干预在特定个体化转移病例中的潜在作用。
