Colonic metastasis from infiltrating ductal breast carcinoma in a male patient: A case report

INTRODUCTION: A colonic metastasis from infiltrating breast ductal carcinoma is a rare phenomenon in the literature, especially in a male. PRESENTATION OF CASE: We present a rare case of a 55-year-old male with a past medical history of breast cancer who presented with signs and symptoms of appendicitis. A computed tomography (CT) scan revealed acute appendicitis in addition to a 2.3 cm cecal mass that correlated with a hypermetabolic region on positron emission testing (PET) the previous year. Analysis of a previously biopsied axillary lymph node demonstrated infiltrating ductal carcinoma. After an appendectomy and a right hemicolectomy were performed, pathologic analysis of the specimen revealed metastatic ductal carcinoma to the cecum. DISCUSSION: Gastrointestinal metastases of breast carcinoma are rare with colonic metastases occurring in approximately 3% of these cases. At the time of diagnosis of these colonic metastases, the disease is often times multifocal in the gastrointestinal tract. Solitary gastrointestinal metastases are less common than both secondary primaries and benign processes. Biopsies obtained during colonoscopy are often non-diagnostic, mandating surgical excision and pathologic examination. CONCLUSION: Although colonic metastases from a primary breast ductal carcinoma are rare, a low level of suspicion must be maintained in a patient with such a history presenting with abdominal symptoms.