Metastatic Occult Primary Lobular Breast Cancer: A Case Report

Breast cancer is the most common malignancy diagnosed in women. Invasive lobular breast cancer (ILC) is the second most common histologic subtype after invasive ductal carcinoma. Metastatic occult primary breast cancer, although rare, is a well-known clinical entity that usually presents with axilla...

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Published inCurēus (Palo Alto, CA) Vol. 16; no. 4; p. e58586
Main Authors Pouptsis, Athanasios, Cano Gimeno, Julia, Martinez Rubio, Carmen, Bañuls Marrades, Marta, Olivan Sasot, Patricia
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 19.04.2024
Cureus
Subjects
Abdomen
Age
Antigens
Ascites
Biopsy
Breast cancer
Case reports
Colon
Colonoscopy
Cytokeratin
Estrogens
Gastroenterology
Hemoglobin
Lymphatic system
Mammography
Medical diagnosis
Metastasis
Oncology
Ovaries
Pelvis
Radiology
Thyroid gland
Tomography
Ultrasonic imaging
lobular
breast cancer
cdk 4/6 inhibitors
lobular breast cancer
metastatic
occult
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Summary:Breast cancer is the most common malignancy diagnosed in women. Invasive lobular breast cancer (ILC) is the second most common histologic subtype after invasive ductal carcinoma. Metastatic occult primary breast cancer, although rare, is a well-known clinical entity that usually presents with axillary lymphadenopathy without a detectable breast tumour. A perimenopausal woman in her 50s presented with abdominal pain, fatigue, and weight loss. Imaging showed peritoneal carcinomatosis with ascites, ovarian masses, and a lesion in the ascending colon. Gastric and colon biopsies showed infiltration from lobular breast cancer. Diagnostic workup, including mammography, breast ultrasound, and breast MRI, showed no evidence of breast pathology or axillary lymphadenopathy. First-line treatment with goserelin, letrozole, and palbociclib commenced with clinical improvement and radiological response. This case illustrates the challenges faced by clinicians in the diagnosis and treatment of lobular breast cancer without an identifiable primary lesion or axillary lymphadenopathy.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.58586