Volume 84 - 2021 - Fasc.2 - Letters
Duodenal metastasis of breast invasive carcinoma of no special type: a rare presentation
The authors read with attention the case report by
Vande Berg and coworkers, published on a previous
issue of this journal, describing a rare diagnosis of
rectal metastases of an incognito invasive lobular breast
carcinoma (ILC), for which immunohistochemistry was
decisive (1). Likewise, we share a similarly rare case of
gastrointestinal metastases of breast carcinoma (BC), in
which immunohistochemistry played a pivotal role.A
55-year-old woman was diagnosed in June 2015 with
an Invasive Breast Carcinoma of no-special-type (IBCNST)
grade III, human epidermal growth factor receptor
2 (HER2) positive, estrogen and progesterone receptors
(ER/PR) negative. Biopsy revealed vascular permeation.
Neoadjuvant chemotherapy and trastuzumab preceded
surgery, performed in December 2015, followed by
radiotherapy and trastuzumab. The patient remained
free of disease until 2017, when a right cerebellar lesion
was diagnosed as BC metastasis and was treated with
stereotactic radiosurgery. In January 2020, the patient
presented with a 1-month history of post-prandial
vomiting, epigastric pain, anorexia, fatigue, and a 10 kg
weight loss. Lab tests were unremarkable, except for small
increase in CA-125 and CA-15.3.
A cystic lesion mimicking pancreatic neoplasm
A 54-year old male patient was admitted with
complaints of periodical pain in the upper abdomen, CA-
19.9-51 U/ml (reference range < 37 U/ml). Blood tests
were normal. However, ultrasound scan results revealed
growth of a pancreatic tumor over 52×38 mm. A CT scan
was performed for further characterization of the lesion.
A tumor mass of 54 mm in diameter of the pancreatic
body was found. There was no differentiation of lesion
border with pancreas body (Fig. 1). Surgical resection
was performed without preoperative biopsy following
the consensus of the International Study Group of
Pancreatic Surgery which states that in the presence of
a solid mass suspicious for malignancy, a biopsy proof
is not required before proceeding with resection (1). A
soft consistence pancreas cyst with pus-like content
was resected during surgical operation....
