Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach

Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach

A 55-year-old woman presented with persistent nausea, vomiting, and weight loss previously attributed to Ménétrier’s disease. On further workup, she was found to have metastatic lobular breast carcinoma causing gastric outlet obstruction, diagnosed by endoscopic ultrasound with fine needle aspiratio...

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Main Authors: Laura L. Ulmer, Ian Cormier, Lokesh K. Jha, Shailender Singh, Kurt W. Fisher, Alexander T. Hewlett
Format: Article
Language:English
Published: Hindawi Limited 2018-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2018/2820352
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spelling doaj-c0ea828bf9734003b08cdc9242f10b6e2020-11-24T23:23:20ZengHindawi LimitedCase Reports in Gastrointestinal Medicine2090-65282090-65362018-01-01201810.1155/2018/28203522820352Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the StomachLaura L. Ulmer0Ian Cormier1Lokesh K. Jha2Shailender Singh3Kurt W. Fisher4Alexander T. Hewlett5Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198-2000, USADepartment of Internal Medicine, University of Nebraska Medical Center, 42nd and Emile Street, Omaha, NE 68198-6805, USADepartment of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198-2000, USAInternal Medicine Division of Gastroenterology-Hepatology, 982000 Nebraska Medical Center, Omaha, NE 68198-2000, USADepartment of Pathology and Microbiology, University of Nebraska Medical Center, 986805 Nebraska Medical Center, Omaha, NE 68198-6805, USAInternal Medicine Division of Gastroenterology-Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198-2000, USAA 55-year-old woman presented with persistent nausea, vomiting, and weight loss previously attributed to Ménétrier’s disease. On further workup, she was found to have metastatic lobular breast carcinoma causing gastric outlet obstruction, diagnosed by endoscopic ultrasound with fine needle aspiration after previous gastric mucosal biopsies were unremarkable. In most reported cases of gastric metastasis from breast cancer, a diagnosis was established by mucosal biopsy. This case is an important reminder that mucosal biopsies can be negative in about 20% of patients with gastric metastasis, which may lead to a delay in diagnosis and treatment. Gastroenterologists should be diligent in taking deeper biopsies if there is a suspicion for gastric metastasis.http://dx.doi.org/10.1155/2018/2820352
collection DOAJ
language English
format Article
sources DOAJ
author Laura L. Ulmer
Ian Cormier
Lokesh K. Jha
Shailender Singh
Kurt W. Fisher
Alexander T. Hewlett
spellingShingle Laura L. Ulmer
Ian Cormier
Lokesh K. Jha
Shailender Singh
Kurt W. Fisher
Alexander T. Hewlett
Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
Case Reports in Gastrointestinal Medicine
author_facet Laura L. Ulmer
Ian Cormier
Lokesh K. Jha
Shailender Singh
Kurt W. Fisher
Alexander T. Hewlett
author_sort Laura L. Ulmer
title Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
title_short Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
title_full Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
title_fullStr Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
title_full_unstemmed Use of Endoscopic Ultrasound in a Diagnostic Dilemma: Metastatic Breast Cancer to the Stomach
title_sort use of endoscopic ultrasound in a diagnostic dilemma: metastatic breast cancer to the stomach
publisher Hindawi Limited
series Case Reports in Gastrointestinal Medicine
issn 2090-6528
2090-6536
publishDate 2018-01-01
description A 55-year-old woman presented with persistent nausea, vomiting, and weight loss previously attributed to Ménétrier’s disease. On further workup, she was found to have metastatic lobular breast carcinoma causing gastric outlet obstruction, diagnosed by endoscopic ultrasound with fine needle aspiration after previous gastric mucosal biopsies were unremarkable. In most reported cases of gastric metastasis from breast cancer, a diagnosis was established by mucosal biopsy. This case is an important reminder that mucosal biopsies can be negative in about 20% of patients with gastric metastasis, which may lead to a delay in diagnosis and treatment. Gastroenterologists should be diligent in taking deeper biopsies if there is a suspicion for gastric metastasis.
url http://dx.doi.org/10.1155/2018/2820352
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