First diagnosed invasive lobular carcinoma of the breast combined with gastric metastasis and bone metastasis - a case report and review of the literature

Sep 24, 2026

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First diagnosed invasive lobular carcinoma of the breast with simultaneous gastric and bone metastases is described as an extremely rare presentation. The clinical and pathological identification of metastatic breast cancer is challenging, and this report presents an apparently first documented case combining initial breast cancer diagnosis with both gastric metastasis and bone metastasis. The patient’s course includes initial gastrointestinal symptoms, diagnostic endoscopy and biopsy, palliative surgical management, confirmatory pathology and systemic evaluation, followed by ongoing follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

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Abstract

Case report

Diagnosis

Interventions

Outcomes

Introduction

Case presentation

Sun et al. BMC Women’s Health (2023) 23:133 [https://doi.org/10.1186/s12905-023-02267-6](https://doi.org/10.1186/s12905-023-02267-6) BMC Women’s Health CASE REPORT Open Access First diagnosed invasive lobular carcinoma of the breast combined with gastric metastasis and bone metastasis: a case report and review of the literature Lin Sun, Jiajia Liu, Meng Guo, Jiaqi Xu and Dan Wang* Abstract Rationale Chinese women topped the list of new breast cancers, the first diagnosed gastric metastasis and bone metastasis is extremely infrequent. The clinical and pathological diagnosis of metastatic breast cancer is difficult. To our knowledge, this is the first reported case of the first diagnosis of breast cancer with both gastric metastasis and bone metastasis. Case report The female patient was found to have abdominal distension for 15 days with nausea and vomiting. The patient underwent a gastroscopy at an outside hospital 4 days ago, showing: duodenal bulb changes, gastric retention and chronic non-atrophic gastritis. Gastroscopic biopsy showed chronic inflammation and edema of the duodenal mucosa with glandular hyperplasia. Conservative treatment was given with no relief of symptoms. She was seen in our hepatobiliary and pancreatic surgery department. After admission, palliative surgery was performed, and the swelling and surrounding involved tissues were taken for examination during surgery. The rapid pathological return could not exclude tumor lesions, and the postoperative pathology confirmed the diagnosis of invasive lobular carcinoma of the breast with gastric metastases, and the systemic examination revealed combined bone metastases. Diagnosis Pathology and immunohistochemistry(IHC), a whole-body bone scan confirmed the first diagnosis of breast cancer with both gastric and bone metastases. Interventions Palliative treatment with bisphosphonates and CDK4/6i (Palbociclib) in combination with AI (Exemestane) was administered. Outcomes The patient is currently under regular evaluation and is being followed up. Keywords Breast cancer, Gastrointestinal metastases, Immunohistochemistry, Diagnosis, Treatment, Prognosis *Correspondence: Dan Wang [wangd99@jlu.edu.cn](wangd99@jlu.edu.cn) Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun 130041, China © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[http://creativeco](http://creativeco)[mmons.org/publicdomain/zero/1.0/](mmons.org/publicdomain/zero/1.0/)) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Sun et al. BMC Women’s Health (2023) 23:133 Introduction In February 2022, the latest data from the National Cancer Center showed that Chinese women topped the list of new breast cancers and also reminded women that they should be screened for breast cancer through regular physical examinations. De

FAQs

Why is diagnosis of metastatic breast cancer difficult in this situation?

Metastatic breast cancer can present with a single metastatic-organ tumor as the first symptom, which complicates clinical and pathological identification. In this report, the initial presentation involves gastric findings that can obscure breast origin.

What initial symptoms led to the patient’s first evaluation?

The patient had abdominal distension for 15 days with nausea and vomiting. Gastroscopy at an outside hospital showed duodenal bulb changes, gastric retention, and chronic non-atrophic gastritis.

How was the final diagnosis confirmed?

Pathology and immunohistochemistry supported invasive lobular carcinoma of the breast with gastric metastases, and systemic examination identified combined bone metastases.

Sep 24, 2026

Uploaded by Finn