Atypical Presentation of Metastatic Breast Cancer: Gastric Outlet Obstruction and Linitis Plastica

Linitis plastica (LP) is a rare stomach cancer that has a high mortality rate due to late presentation and limited available therapies. LP has a varied clinical presentation and can present at all stages. LP can be a primary or secondary neoplastic process. Rarely, it occurs secondary to breast cancer (BC). In this case report, we present an 88-year-old female patient who has a history of right breast ductal adenocarcinoma. She underwent chemoradiation eight years ago and was in remission when she presented with nausea, vomiting, weakness, and jaundice. During an endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, multiple biopsies were taken of epigastric lymph nodes and the gastric wall. The biopsy showed metastatic BC, and the lymph nodes were positive for metastatic adenocarcinoma, resulting in a diagnosis of LP secondary to BC. Although difficult to diagnose, this case report details the need for a lower threshold of endoscopic evaluation in a patient with a history of BC. It also emphasizes the need for further research into potential treatment options.