We report a case of breast metastasis to the sigmoid colon in a 69-year-old woman who underwent surgery 18 years ago (1994) for a lobular carcinoma of the right breast, with modified radical mastectomy followed by chemotherapy (CT)
She came to the emergency room with a 48-hour history of abdominal pain associated with nausea, vomiting and absence of ventosis.
On physical examination, the abdomen was distended and painful in general with signs of peritoneal irritation.
A discrete leukocytosis (13.62x103) was observed.
Another CT scan suggested a supra-pelvic mass with IV contrast, which showed a neoplasic lesion in the proximal portion of the sigmoid colon. The image suggested a collection in the left gout of about 4 cm.
Peritonitis was diagnosed as an emergency surgical procedure in which a perforation of the sigmoid colon was observed.
A terminal sigmoidectomy was performed in the left flank.
During the postoperative period, the patient evolved favorably and was discharged after seven days.
The subsequent pathological study of the tumor reports metastasis of poorly differentiated carcinoma compatible with primary breast.
The neoplasm has immunohistochemistry negativity for estrogen, progesterone and HER 2 NEU receptors (HERCEPTEST), while it presents positivity with anti-CK7 antibody typically positive in most breast carcinomas and negative in colon.
The patient has received postoperative systemic chemotherapy, remains asymptomatic and disease-free one year after surgery (negative PET-CT during follow-up).
Currently waiting for surgery for intestinal transit reconstruction.
