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Metastatic breast cancer to the rectum: A case report with emphasis on MRI features
Li Ching Lau1, Bernard Wee, Shi Wang
1Department of Diagnostic Imaging Department of Pathology, National University Hospital, Singapore, Singapore.
Rationale:
Less than 1% of breast carcinomas metastasize to the gastrointestinal tract. The diagnosis is frequently not recognized especially when the history of breast carcinoma is remote.
Patient Concerns:
A 61-year-old female with a remote history of breast carcinoma presented with a 3-month history of change in bowel habits. Colonoscopy showed a circumferential rectal mass with initial impression of primary rectal cancer. MRI of the rectum showed findings that are atypical for primary rectal cancer.
Diagnoses:
Deep biopsy of the rectal mass confirmed lobular breast carcinoma metastasis to the rectum.
Intervention And Outcomes:
The patient was treated with radiotherapy and hormonal therapy. She is symptomatically well 2 years after presentation and remains on hormonal therapy.
Lessons:
Lobular breast cancer which metastasizes to the rectum can mimic primary rectal cancer clinically. The unique MRI features described in our case when present with a concordant history of lobular breast carcinoma should alert the radiologist to the possibility of this diagnosis which has important treatment implications.
