Jiao X, Xing FZ, Zhai MM, Sun P. Successful treatment of breast metastasis from primary transverse colon cancer: A case report. World J Clin Cases 2023; 11(11): 2559-2566 [PMID: 37123317 DOI: 10.12998/wjcc.v11.i11.2559]
Corresponding Author of This Article
Peng Sun, PhD, Doctor, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261041, Shandong Province, China. 1105031456@qq.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2023; 11(11): 2559-2566 Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2559
Successful treatment of breast metastasis from primary transverse colon cancer: A case report
Xin Jiao, Fang-Zhou Xing, Mi-Mi Zhai, Peng Sun
Xin Jiao, Fang-Zhou Xing, Peng Sun, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang 261041, Shandong Province, China
Mi-Mi Zhai, Department of Digestive System, Weifang People’s Hospital, Weifang 261041, Shandong Province, China
Author contributions: Jiao X reviewed the literature and contributed to manuscript drafting; Xing FZ was the patient’s primary doctor and substantially contributed to the conception and design of the study and acquisition of the data; Zhai MM substantially contributed to the data acquisition; Sun P was responsible for the revision of the manuscript for important intellectual content.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Sun, PhD, Doctor, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261041, Shandong Province, China. 1105031456@qq.com
Received: January 18, 2023 Peer-review started: January 18, 2023 First decision: February 7, 2023 Revised: February 13, 2023 Accepted: March 23, 2023 Article in press: March 23, 2023 Published online: April 16, 2023
Abstract
BACKGROUND
The incidence of colon cancer is increasing worldwide. Treatments for colon cancer include surgery and surgery combined with chemotherapy and radiotherapy, but the median survival rate is still poor. Colon cancer most commonly metastasizes to the lymph nodes, lungs, liver, peritoneum, and brain, but breast metastasis is rare. There is no agreement on its treatment.
CASE SUMMARY
A 23-year-old woman was admitted to our hospital for further treatment with a history of acute abdominal pain, nausea, and vomiting. Her physical examination and computed tomography scan revealed an abdominal tumor. Transverse colectomy was successfully performed. Histopathological examination revealed that the tumor was a mucosecretory adenocarcinoma with signet ring cells. The patient inadvertently found a mass in the outer upper quadrant of the right breast after four cycles of XELOX chemotherapy [oxaliplatin 130 mg/m2, d1, intravenous (iv) drip for 2 h; capecitabine 1000 mg/m2, po, bid, d1–d14]. After discussion with the patient, we performed a lumpectomy and frozen biopsy. The latter revealed that the breast tumor was intestinal metastasis. Genetic testing showed wild-type RAS and BRAF. So we replaced the original chemotherapy with FOLFIRI [irinotecan 180 mg/m2, d1, iv drip for 3–90 min; leucovorin 400 mg/m2, d1, iv drip for 2 h; 5-fluorouracil (5-FU) 400 mg/m2, d1 and 5-FU 1200 mg/(m2 d) × 2 d, continuous iv drip for 46–48 h] + cetuximab (500 mg/m2, d1, iv drip for 2 h). Serum levels of tumor markers returned to normal after several treatment cycles, and there was no evidence of tumor recurrence or metastasis.
CONCLUSION
Breast metastasis from colon cancer is rare. Radical breast surgery should be avoided unless needed for palliation. Chemotherapy combined with targeted therapy should be the first choice.
Core Tip: Breast metastasis from colon cancer is rare. The prognosis is poor and conservative treatment is mainly adopted. We present a rare case of breast metastasis from colon cancer in a young patient who received chemotherapy (FOLFIRI) combined with targeted therapy (cetuximab) after undergoing transverse colectomy and lumpectomy. There was no recurrence or metastasis during the 16-mo follow-up after lumpectomy, and the treatment effect was good.
