Ileal metastasis masquerading as Crohn’s in lobular carcinoma of the breast, years after initial treatment and review of literature

Altaf G. Haji; Shashikanth Vijayaraghavalu; Naveen Sivakumar; Sadaf Zehra; Kalimuthu Marimuthu; Lourdusamy Arul Selvam; Bala Piramanayagam

doi:10.18203/2349-2902.isj20233554

Authors

Altaf G. Haji Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Shashikanth Vijayaraghavalu Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Naveen Sivakumar Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Sadaf Zehra Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Kalimuthu Marimuthu Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Lourdusamy Arul Selvam Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
Bala Piramanayagam Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom

DOI:

https://doi.org/10.18203/2349-2902.isj20233554

Keywords:

Lobular cancer breast, Gastrointestinal metastasis, Inflammatory bowel disease

Abstract

Gastrointestinal (GI) metastases masquerading as Crohn’s years after treated lobular carcinoma of breast is a diagnostic challenge. In some cases, the interval between the primary breast cancer and gastrointestinal metastasis is so long (3-20 years) that the medical records for diagnosis including history might be missed. The susceptibility of invasive lobular cancer (ILC) to metastasize to gut is many times greater than invasive ductal carcinoma (IDC) (4.5% versus 0.2%, respectively). We report the case of lobular breast carcinoma metastasizing to the terminal ileum and ileocecal junction 7 years following treatment of right sided lobular breast cancer in 60 plus-year-old women. Radiological and endoscopic findings can be difficult to distinguish from inflammatory bowel disease or from primary carcinoma of the GI tract. Histopathological and immunochemistry assessments usually help in reaching the diagnosis. A high index of suspicion and awareness regarding such presentations can help in making an accurate diagnosis and subsequent treatment planning.

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