Journal Article

Metastatic breast cancer presenting as a gallstone ileus

Shaheel M. Sahebally, Rishabh Sehgal, Justin Kelly, Peter N. Faul and David Waldron

in Journal of Surgical Case Reports

Volume 2013, issue 12 Published in print December 2013 |
Published online December 2013 | e-ISSN: 2042-8812 | DOI: http://dx.doi.org/10.1093/jscr/rjt113

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Metastatic breast cancer to the small bowel (SB) presenting as gallstone ileus and resulting in SB obstruction has not been described previously. A 76-year-old woman with previous metastatic breast cancer to the axial spine and hips presented with abdominal pain and bilious vomiting. CT scanning revealed SB obstruction consistent with gallstone ileus. The patient underwent two segmental SB resections for distal ileal strictures mimicking what appeared to be macroscopic Crohn's disease. The entero-biliary fistula was undisturbed. Pathological analysis revealed the dual pathologies of gallstone ileus and metastatic carcinoma from a breast primary causing luminal SB obstruction. Improvements in staging and treatment modalities have contributed to the increased overall long-term survival for breast cancer, compelling clinicians to consider metastatic breast cancer as a differential diagnosis in women presenting with new onset of gastrointestinal symptoms in order that appropriate treatment be administered in a timely fashion.

Journal Article.  1109 words.  Illustrated.

Subjects: Gastro-intestinal and Colorectal Surgery

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