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Session: ePoster: Other Neoplasia and Endoscopy 4 (Mon8)

EP645 - Metastatic invasive lobular carcinoma presenting as bowel obstruction and retroperitoneal fibrosis: A case report

Monday, May 12, 2025
8:32 AM – 8:37 AM PT
Location: Monitor 6, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Rosa I. Alers-Talavera, MD

    Fellow
    Greater Baltimore Medical Center
    Towson, MD, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • VC

    Valerie Cabrera-Leon, MD

    Attending
    Greater Baltimore Medical Center
    Towson, Maryland, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Rosa I. Alers-Talavera, MD: This individual has no financial relationships with ineligible companies.
Valerie Cabrera-Leon, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Invasive lobular carcinoma (ILC) only represents 10% of breast cancer in the United States; it differs from its more frequent counterpart by being more frequent to spread to the gastrointestinal and urinary tract lining. However, the invasion presenting as a bowel obstruction is relatively rare.

Methods/Interventions: A 71 y/o female patient with a history of stage II breast cancer (ER/PR positive, HER2 negative) s/p bilateral mastectomies with reconstruction over a decade ago who presented with several months’ history of abdominal cramps, early satiety, changes in bowel habits, and weight loss who presented with small bowel obstruction secondary to cecal mass. Open right colectomy was performed, and operative findings were relevant for fibrotic and thickened mesentery. Pathology revealed metastatic invasive lobular carcinoma.

Results/Outcomes: The patient had an uneventful postoperative course regarding her colon surgery but has presented with other manifestations of her disease, which include chronic pain, bile duct dilation, dilated pancreatic duct, and pancreatitis. A recent upper endoscopy showed diffuse wall thickening in the duodenal bulb and in the second portion of the duodenum with an area of stenosis s/p duodenal stent, biopsy positive for metastatic ILC. Currently on treatment with ribociclib and letrozole.

Conclusion/Discussion: This case represents an uncommon presentation of bowel obstruction and retroperitoneal fibrosis secondary to metastatic breast cancer. Even when cases like this are unfortunate and rare to find, it is essential to consider the possible implications of new-onset gastrointestinal symptoms in patients with a history of ILC to be able to provide earlier care.