Breast cancer often metastasizes to the lung, bone, pleura, and liver. Except for the liver, intraabdominal organs, especially the colon may be a rare site for distant metastasis from breast cancer. We experienced a case of metastatic colon cancer of breast cancer which progressed to the termination due to association of perforated apendicitis.
A 58-year-old woman with a previous history of undergoing extended radical mastectomy for left breast cancer in Stage IIIa in December 1988 visited a nearby hospital because of abdominal distension and abdominal defecation in November 1991. Bariumenema revealed narrowings of the transverse and sigmoid colons, patient was immediately admitted to the hospital, because she developed abdominal pain, anorexia and general fatigue. Two days after admission, the patient suddenly fell into shock. Emergency surgery was carried out, but she died of septicemia. Pathological postmortem diagnosis was panperitonitis due to perforation of associated appendicitis. Metastatic foci of invasive lobular carcinoma of the breast were detected in the colon, ovary and uterus.
This case calls for reflection that careful observation of clinical course and examination should offer correct diagnosis of metastasis to the extrahepatic organs in the abdominal cavity from breast cancer, if no lesions are detected in the common sites for metastasis.