Lower genital tract metastases at time of first diagnosis of mammary invasive lobular carcinoma

Abstract

Although breast cancer is a major health problem worldwide, metastatic disease to the lower genital tract remains to be a rare event. A 64-year old woman was admitted to our hospital due to newly diagnosed ascites and peripheral edema. A computer tomography had shown peritoneal carcinosis but no clear evidence of an intraabdominal mass. CA 12-5 levels were elevated. Physical examination of the breast did not show any abnormal findings, except for the fact that the patient was post bilateral breast augmentation in 1999. The peritoneal carcinosis was thought to originate from the ovaries or the endometrium and therefore the patient underwent a laparotomy with hysterectomy, bilateral salpingoovariectomy and omentectomy. Histological findings revealed a low differentiated adenocarcinoma, most likely originating from primary breast cancer. A bilateral mammography was suspicious of a tumour in the left breast which was confirmed in a second surgery. Histology showed a moderately differentiated invasive-lobular breast cancer. To our knowledge, this is the first report about metastasis to the lower genital tract on initial presentation of an invasive-lobular carcinoma. In the differential diagnosis of peritoneal carcinosis, metastases of an invasive-lobular carcinoma should be considered.