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<p>Breast cancer metastasis to the colon is rare, occurring in less than 1% of patients with metastatic breast cancer. Invasive lobular carcinoma (ILC) exhibits a distinct tropism for the gastrointestinal tract and adnexa, often presenting with atypical imaging features that mimic primary tumors. We report a case of a 58-year-old woman with a history of right breast ILC who presented with incidental pelvic masses on ultrasound five years after mastectomy. 2-[¹⁸F]FDG PET/CT revealed multifocal hypermetabolic lesions in the transverse colon wall and bilateral adnexa. CT enterography and colonoscopy confirmed a stenotic colonic lesion with smooth mucosa. Postoperative pathology following right hemicolectomy, hysterectomy, and bilateral salpingo-oophorectomy confirmed metastatic breast carcinoma involving the right colon and bilateral adnexa. This case highlights the critical role of PET/CT in detecting occult gastrointestinal metastases in patients with ILC and underscores the importance of considering metastatic disease in the differential diagnosis of colonic lesions in this population.</p>

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Breast cancer metastasis to the colon mimicking primary colorectal carcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Qingkui Liu,
  • Jianheng Gao,
  • Hongxing Yang,
  • Xiaoshan Chen,
  • Yaqi He

摘要

Breast cancer metastasis to the colon is rare, occurring in less than 1% of patients with metastatic breast cancer. Invasive lobular carcinoma (ILC) exhibits a distinct tropism for the gastrointestinal tract and adnexa, often presenting with atypical imaging features that mimic primary tumors. We report a case of a 58-year-old woman with a history of right breast ILC who presented with incidental pelvic masses on ultrasound five years after mastectomy. 2-[¹⁸F]FDG PET/CT revealed multifocal hypermetabolic lesions in the transverse colon wall and bilateral adnexa. CT enterography and colonoscopy confirmed a stenotic colonic lesion with smooth mucosa. Postoperative pathology following right hemicolectomy, hysterectomy, and bilateral salpingo-oophorectomy confirmed metastatic breast carcinoma involving the right colon and bilateral adnexa. This case highlights the critical role of PET/CT in detecting occult gastrointestinal metastases in patients with ILC and underscores the importance of considering metastatic disease in the differential diagnosis of colonic lesions in this population.