Abstract
Hyperplastic polyps of the stomach are regarded as benign. However, in rare cases they may contain incipient primary carcinomas. To our knowledge, breast carcinoma metastatic to a gastric hyperplastic polyp has not yet been reported. We describe the case of a 69-year-old woman to whom a gastric polyp was endoscopically excised. The patient had previously undergone a right mastectomy for mixed, invasive ductal and lobular carcinoma 5 years earlier. Histological sections from the gastric lesion showed typical features of hyperplastic polyp with foci of poorly differentiated adenocarcinoma including signet ring cells infiltrating the lamina propria. The histologic findings were consistent with a primary gastric cancer. However, the carcinoma cells were immunopositive for estrogen and progesterone receptors and GATA3 and negative for CDX2, Hep Par 1, and MUC5AC. E-cadherin showed membranous reactivity in some of the carcinoma cells while in others it was negative. Accordingly, metastatic mixed, lobular and ductal breast carcinoma was diagnosed. We conclude that metastatic adenocarcinoma mimicking primary gastric cancer can be rarely encountered in hyperplastic gastric polyps.
Highlights
Metastatic disease involving the stomach is a rare occurrence
All primary malignancies can metastasize to the stomach, gastric metastases most often originate from malignant melanomas or carcinomas of the breast, lung, and esophagus [2]
We present the case of a hyperplastic gastric polyp containing metastatic breast carcinoma that simulated primary gastric cancer
Summary
Metastatic disease involving the stomach is a rare occurrence. In a series of 771 patients with gastric tumors found at endoscopy, only 2.6% were secondary neoplasms [1]. All primary malignancies can metastasize to the stomach, gastric metastases most often originate from malignant melanomas or carcinomas of the breast, lung, and esophagus [2]. Metastatic lobular breast carcinoma may resemble advanced gastric cancer with features of linitis plastica [3, 4]. They are regarded as nonneoplastic, development of primary adenocarcinoma may rarely occur within these polyps [5,6,7,8]. Metastatic adenocarcinoma to a gastric hyperplastic polyp has not been yet reported. We present the case of a hyperplastic gastric polyp containing metastatic breast carcinoma that simulated primary gastric cancer
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