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. 2025 Sep 9;13(9):e70881.
doi: 10.1002/ccr3.70881. eCollection 2025 Sep.

Gastric Metastases From Invasive Breast Lobular Carcinoma, Identified by [18F]FDG PET/CT, 20 Years After Primary Diagnosis: A Case Report

Alina Diana Ilonca  1 , Amélie Gudin-de-Vallerin  2 , Sophie Guillemard  1 , Marie-Claude Eberle  1 , Jeanne Briant  3 , Séverine Guiu  4   5 , Emmanuel Deshayes  1   5 , Cyril Fersing  1   6
Affiliations

Gastric Metastases From Invasive Breast Lobular Carcinoma, Identified by [18F]FDG PET/CT, 20 Years After Primary Diagnosis: A Case Report

Alina Diana Ilonca et al. Clin Case Rep. .

Abstract

Invasive lobular carcinoma (ILC) of the breast is a rare subtype of breast cancer with distinct metastatic patterns. Although gastrointestinal metastases are rare, they can occur years after initial treatment. This case highlights the diagnostic challenges and management of late-onset gastric metastases. A 68-year-old woman with a history of ILC treated 20 years earlier presented with elevated tumor markers. [18F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) revealed hypermetabolic lesions in the stomach and esophagus in this patient with previously diagnosed gastritis and gastroesophageal reflux disease. Endoscopy and biopsies confirmed the presence of metastatic ILC in the stomach. Adjustment of treatment, including exemestane and everolimus, followed by paclitaxel and tamoxifen, resulted in partial disease control. Late-onset gastrointestinal metastases of ILC are uncommon and require special vigilance, particularly in patients with associated benign gastrointestinal pathologies, which may delay diagnosis. Persistent or new-onset gastrointestinal symptoms in breast cancer patients warrant thorough evaluation, including FDG PET/CT imaging and histological confirmation.

Keywords: PET/CT imaging; case report; gastrointestinal metastases; immunohistochemistry; lobular carcinoma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
FDG PET/CT imaging showing a focal and high metabolism areas in the gastric region (blue arrows), SUVmax 6.3, on MIP (maximum‐intensity projection) images (A), axial PET slice (B) and axial fused PET/CT slice (C, D).
FIGURE 2
FIGURE 2
Endoscopy images showing ulcerations of the fundic region.
FIGURE 3
FIGURE 3
Representative images of immunohistochemistry staining results showing hematoxylin–eosin‐saffron (HES) staining (A, E), CKAE1/AE3 (B), E‐cadherin (F), GATA3 (C), TRPS1 (G), estrogen receptor (D) and progesterone receptor (H).
FIGURE 4
FIGURE 4
Comparison of FDG PET/CT images taken in April 2024 (top) and October 2023 (bottom), on axial fused PET/CT slice (left, middle) and axial PET slice (right), showing a partial response of the cardia lesion and a complete responses of other gastric lesions, with disappearance of the focal uptake in the antral‐fundic region.
FIGURE 5
FIGURE 5
Comparison of FDG PET/CT images taken in July 2024 (A, B), October 2024 (C, D) and January 2025 (E, F), on axial fused PET/CT slice (A, C, E) and axial PET slice (B, D, F).
See this image and copyright information in PMC

References

    1. Momenimovahed Z. and Salehiniya H., “Epidemiological Characteristics of and Risk Factors for Breast Cancer in the World,” BCTT 11 (2019): 151–164, 10.2147/BCTT.S176070. - DOI - PMC - PubMed
    1. Ferlay J., Soerjomataram I., Ervik M., et al., GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 [Internet] (International Agency for Research on Cancer, 2012).
    1. Sastre‐Garau X., Jouve M., Asselain B., et al., “Infiltrating Lobular Carcinoma of the Breast. Clinicopathologic Analysis of 975 Cases With Reference to Data on Conservative Therapy and Metastatic Patterns,” Cancer 77, no. 1 (1996): 113–120, 10.1002/(SICI)1097-0142(19960101)77:1<113::AID-CNCR19>3.0.CO;2-8. - DOI - PubMed
    1. Benitez Fuentes J. D., Morgan E., De Luna Aguilar A., et al., “Global Stage Distribution of Breast Cancer at Diagnosis: A Systematic Review and Meta‐Analysis,” JAMA Oncology 10, no. 1 (2024): 71, 10.1001/jamaoncol.2023.4837. - DOI - PMC - PubMed
    1. Bamias A., Baltayiannis G., Kamina S., et al., “Rectal Metastases From Lobular Carcinoma of the Breast: Report of a Case and Literature Review,” Annals of Oncology 12, no. 5 (2001): 715–718, 10.1023/A:1011192827710. - DOI - PubMed

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