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Vinorelbine induced perforation of a metastatic gastric lesion

BACKGROUND: Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637–641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and liter...

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Autores principales: Mullally, W. J., O’Súilleabháin, C. B., Brady, C., O’Reilly, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550518/
https://www.ncbi.nlm.nih.gov/pubmed/28039597
http://dx.doi.org/10.1007/s11845-016-1536-1
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author Mullally, W. J.
O’Súilleabháin, C. B.
Brady, C.
O’Reilly, S.
author_facet Mullally, W. J.
O’Súilleabháin, C. B.
Brady, C.
O’Reilly, S.
author_sort Mullally, W. J.
collection PubMed
description BACKGROUND: Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637–641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review. METHODS: A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler’s sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma. RESULTS: Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071–1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761–1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma. CONCLUSION: This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted in gastric perforation. Five years after gastric perforation she resumed palliative chemotherapy after progression on sequential hormonal therapies.
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spelling pubmed-55505182017-08-24 Vinorelbine induced perforation of a metastatic gastric lesion Mullally, W. J. O’Súilleabháin, C. B. Brady, C. O’Reilly, S. Ir J Med Sci Case Based Reviews BACKGROUND: Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637–641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review. METHODS: A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler’s sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma. RESULTS: Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071–1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761–1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma. CONCLUSION: This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted in gastric perforation. Five years after gastric perforation she resumed palliative chemotherapy after progression on sequential hormonal therapies. Springer London 2016-12-30 2017 /pmc/articles/PMC5550518/ /pubmed/28039597 http://dx.doi.org/10.1007/s11845-016-1536-1 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Based Reviews
Mullally, W. J.
O’Súilleabháin, C. B.
Brady, C.
O’Reilly, S.
Vinorelbine induced perforation of a metastatic gastric lesion
title Vinorelbine induced perforation of a metastatic gastric lesion
title_full Vinorelbine induced perforation of a metastatic gastric lesion
title_fullStr Vinorelbine induced perforation of a metastatic gastric lesion
title_full_unstemmed Vinorelbine induced perforation of a metastatic gastric lesion
title_short Vinorelbine induced perforation of a metastatic gastric lesion
title_sort vinorelbine induced perforation of a metastatic gastric lesion
topic Case Based Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550518/
https://www.ncbi.nlm.nih.gov/pubmed/28039597
http://dx.doi.org/10.1007/s11845-016-1536-1
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