Lobular Breast Carcinoma Revealed by a Stenotic Ileal Metastasis

Small bowel obstruction (SBO) is a condition frequently encountered in the emergency department. We describe a case of a 49-year-old woman admitted for acute abdominal pain due to an ileal stenosis that proved to be metastatic invasive lobular carcinoma of the breast. Mammography and ultrasonography were negative, while breast MRI showed only subtle lesions. Histology combined with immunohistochemistry confirmed the diagnosis, consistent with an occult primary tumor. The patient underwent segmental ileal resection, followed by hormonal therapy combined with a CDK4/6 inhibitor, with an uncomplicated early postoperative course. This report underlines the importance of considering atypical causes of acute SBO in women, particularly when initial imaging is inconclusive.