Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia
Background. Intra-abdominal metastases of invasive lobular breast cancer (ILBC) may be insidious. We report a case of metastatic ILBC that presented with dysphagia within weeks of a negative mammogram and before the development of intra-abdominal symptoms. Case. A 70-year-old female developed esopha...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/7065674 |
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| author | Lilit Karapetyan Heather Laird-Fick Reuben Cuison |
| author_facet | Lilit Karapetyan Heather Laird-Fick Reuben Cuison |
| author_sort | Lilit Karapetyan |
| collection | DOAJ |
| description | Background. Intra-abdominal metastases of invasive lobular breast cancer (ILBC) may be insidious. We report a case of metastatic ILBC that presented with dysphagia within weeks of a negative mammogram and before the development of intra-abdominal symptoms. Case. A 70-year-old female developed esophageal dysphagia. She underwent EGD which showed a short segment of stricture of the distal esophagus without significant mucosal changes. Biopsy was unremarkable and patient underwent lower esophageal sphincter (LES) dilation. Severe progressive dysphagia led to esophageal impaction and three LES dilatations. CT scan showed bilateral pleural effusions, more prominent on right side, and ascites. The pleural effusions were transudative. Repeat EGD with biopsy showed lymphocytic esophagitis, and she was started on swallowed fluticasone. Abdominal ultrasound with Doppler showed that the main portal vein had atypical turbulent flow that was felt to possibly be due to retroperitoneal process. The patient underwent diagnostic laparoscopy which revealed diffuse punctate lesions on the peritoneum. Pathology was consistent with metastatic ILBC. Conclusion. Dysphagia in the setting of peritoneal carcinomatosis from metastatic ILBC is a rare finding. The case highlights the importance of metastatic ILBC as a differential diagnosis for female patients with progressive dysphagia and associated ascites or pleural effusions. |
| format | Article |
| id | doaj-art-c19be3ab3b7b4504b672611e349ebb66 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-c19be3ab3b7b4504b672611e349ebb662025-02-03T01:10:44ZengWileyCase Reports in Oncological Medicine2090-67062090-67142017-01-01201710.1155/2017/70656747065674Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal DysphagiaLilit Karapetyan0Heather Laird-Fick1Reuben Cuison2Department of Medicine, Michigan State University College of Human Medicine, 788 Service Road Suite B301, East Lansing, MI, USADepartment of Medicine, Michigan State University College of Human Medicine, 788 Service Road Suite B301, East Lansing, MI, USAPathology Department, EW Sparrow Hospital, 1215 East Michigan Avenue, Lansing, MI 48909-7980, USABackground. Intra-abdominal metastases of invasive lobular breast cancer (ILBC) may be insidious. We report a case of metastatic ILBC that presented with dysphagia within weeks of a negative mammogram and before the development of intra-abdominal symptoms. Case. A 70-year-old female developed esophageal dysphagia. She underwent EGD which showed a short segment of stricture of the distal esophagus without significant mucosal changes. Biopsy was unremarkable and patient underwent lower esophageal sphincter (LES) dilation. Severe progressive dysphagia led to esophageal impaction and three LES dilatations. CT scan showed bilateral pleural effusions, more prominent on right side, and ascites. The pleural effusions were transudative. Repeat EGD with biopsy showed lymphocytic esophagitis, and she was started on swallowed fluticasone. Abdominal ultrasound with Doppler showed that the main portal vein had atypical turbulent flow that was felt to possibly be due to retroperitoneal process. The patient underwent diagnostic laparoscopy which revealed diffuse punctate lesions on the peritoneum. Pathology was consistent with metastatic ILBC. Conclusion. Dysphagia in the setting of peritoneal carcinomatosis from metastatic ILBC is a rare finding. The case highlights the importance of metastatic ILBC as a differential diagnosis for female patients with progressive dysphagia and associated ascites or pleural effusions.http://dx.doi.org/10.1155/2017/7065674 |
| spellingShingle | Lilit Karapetyan Heather Laird-Fick Reuben Cuison Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia Case Reports in Oncological Medicine |
| title | Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia |
| title_full | Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia |
| title_fullStr | Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia |
| title_full_unstemmed | Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia |
| title_short | Metastatic Invasive Lobular Breast Cancer Presenting Clinically with Esophageal Dysphagia |
| title_sort | metastatic invasive lobular breast cancer presenting clinically with esophageal dysphagia |
| url | http://dx.doi.org/10.1155/2017/7065674 |
| work_keys_str_mv | AT lilitkarapetyan metastaticinvasivelobularbreastcancerpresentingclinicallywithesophagealdysphagia AT heatherlairdfick metastaticinvasivelobularbreastcancerpresentingclinicallywithesophagealdysphagia AT reubencuison metastaticinvasivelobularbreastcancerpresentingclinicallywithesophagealdysphagia |