EP496 - Metastatic Invasive Lobular Carcinoma of the Breast mimicking healed Gastric Ulcer: A Case Report

Abstract Introduction Breast cancer metastasizing to the stomach as a new presentation is highly unusual. We report a 77-year-old female with such presentation. Case Presentation A 77-year-old female investigated for significant weight loss. She denied any upper or lower gastrointestinal symptoms. She had bidirectional scopes. Colonoscopy showed only diverticulosis. Two gastroscopies revealed non-specific stellar shaped areas in the anterior antrum wall mimicking a healed gastric ulcer. Biopsies confirmed metastatic lobular carcinoma of the breast, ER+ve, HER2 negative. On further clinical examination she had large mass upper outer quadrant with palpable enlarged nodes. Staging CT scan showed couple of hyper enhancing foci in the right breast which may be potential candidates for primary tumour and enlarged right axillary nodes. Subsequently she had an ultrasound guided biopsy of the breast lesion confirmed invasive lobular cancer. Patient has been referred to the breast MDT for breast and lymph node biopsy. Discussion The incidence of GI metastatic disease from a primary breast cancer is less than 1%. It is more common to diagnose in patients with prior history and treatment for primary breast malignancy. However, occasionally it can be encountered prior to the diagnosis of the primary tumour. Hence, index of high suspicion is required as the endoscopic findings are non-specific.