title: Gastric and Colorectal Metastases of Lobular Breast Carcinoma: A Case Report.
abstract: BACKGROUND
  Occurrence of gastric metastasis as the first symptom of breast carcinoma with a long period of latency before presentation of the primary breast carcinoma is rare.
  
  
  METHODS
  A patient with gastric metastasis as the first symptom of lobular breast carcinoma, treated by neoadjuvant preoperative chemoradiotherapy and total gastrectomy, with complete local control. Fourteen months after presentation of the gastric metastasis a primary lobular breast carcinoma was discovered, treated by radiotherapy, chemotherapy and hormonal treatment with complete local response. Twenty-three months after diagnosis of breast cancer multiple colorectal metastases from the breast cancer occurred, which were treated by chemotherapy and hormonal treatment. Eighty-six months after diagnosis of gastric metastasis the patient died due to progression of cancer.
  
  
  CONCLUSIONS
  Metastases to gastrointestinal or gynaecological tracts are more likely in invasive lobular carcinoma than invasive ductal cancer. The pathologist should determine whether or not they check estrogen and progesterone receptor status not simply by signet ring cell morphology but also by consideration of clinic-pathological correlation of the patient, such as the presence of a past history of breast cancer, or the colorectal localization of poorly differentiated carcinoma, which may occur less frequently than in the stomach.
authors.affiliation: Department of Oncology and Radiotherapy, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic. david.buka@fnhk.cz.
authors.forename: David
authors.initials: D
authors.lastname: Buka
authors.affiliation: Department of Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Dvořák
authors.affiliation: Department of Oncology, Regional Hospital Liberec, Liberec, Czech Republic.
authors.forename: Igor
authors.initials: I
authors.lastname: Richter
authors.affiliation: Department of Pathology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic.
authors.forename: Nikolov Dimitar
authors.initials: ND
authors.lastname: Hadzi
authors.affiliation: 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Cyrany
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000556:secondary* / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods; D015179:Colorectal Neoplasms / Q000556:secondary* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D013274:Stomach Neoplasms / Q000556:secondary* / Q000628:therapy
keywords: Gastric metastasis from breast carcinoma; Lobular breast carcinoma; Multiple colorectal metastases from breast carcinoma