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Rare common bile duct metastasis of breast cancer: A case report and literature review

Authors
  • Tang, Jie
  • Zhao, Guang-Xi
  • Deng, Shuang-Shuang
  • Xu, Ming
Type
Published Article
Journal
World Journal of Gastrointestinal Oncology
Publisher
Baishideng Publishing Group Inc
Publication Date
Feb 15, 2021
Volume
13
Issue
2
Pages
147–156
Identifiers
DOI: 10.4251/wjgo.v13.i2.147
PMID: 33643530
PMCID: PMC7896423
Source
PubMed Central
Keywords
License
Green

Abstract

BACKGROUND Breast cancer is the most common tumor in women, and about one-third of cases develop metastatic disease. However, metastatic breast cancer rarely invades the common bile duct (CBD) directly without involving the liver, and involvement of the gastrointestinal tract is rare. Cases of such metastases pose a particular diagnostic challenge. CASE SUMMARY A 55-year-old female presented to the Department of Gastroenterology with complaint of a 2 mo history of right upper abdominal pain accompanied by pain in the right back, aggravated after eating greasy diet. The patient had received a diagnosis of breast cancer 3 years prior. Physical examination showed obvious superficial protuberant erythema on the left neck and chest skin, with slight tenderness and burning sensation. Endoscopic retrograde cholangiopancre-atography showed an obstruction at the end of the CBD. Histopathology of the CBD and symptomatic skin biopsies showed positivity for cytokeratin 7 and trans-acting T-cell-specific transcription factor breast cancer biomarkers. A cancer embolus was also found in the skin vasculature. Accordingly, the diagnosis of breast cancer metastases to the skin and biliary ducts was made. A plastic biliary sent was placed, which relieved the right upper abdominal pain and protected against unnecessary hepatectomy surgery. CONCLUSION Although rare, biliary metastasis should be considered in patients with bile duct stenosis and a history of breast cancer.

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