Metastatic breast cancer to the rectum: A case report with emphasis on MRI features

Medicine (Baltimore). 2017 Apr;96(17):e6739. doi: 10.1097/MD.0000000000006739.


Rationale: Less than 1% of breast carcinomas metastasize to the gastrointestinal tract. The diagnosis is frequently not recognized especially when the history of breast carcinoma is remote.

Patient concerns: A 61-year-old female with a remote history of breast carcinoma presented with a 3-month history of change in bowel habits. Colonoscopy showed a circumferential rectal mass with initial impression of primary rectal cancer. MRI of the rectum showed findings that are atypical for primary rectal cancer.

Diagnoses: Deep biopsy of the rectal mass confirmed lobular breast carcinoma metastasis to the rectum.

Intervention and outcomes: The patient was treated with radiotherapy and hormonal therapy. She is symptomatically well 2 years after presentation and remains on hormonal therapy.

Lessons: Lobular breast cancer which metastasizes to the rectum can mimic primary rectal cancer clinically. The unique MRI features described in our case when present with a concordant history of lobular breast carcinoma should alert the radiologist to the possibility of this diagnosis which has important treatment implications.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy
  • Carcinoma, Lobular / diagnostic imaging
  • Carcinoma, Lobular / pathology*
  • Carcinoma, Lobular / therapy
  • Delayed Diagnosis
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Rectal Neoplasms / diagnostic imaging*
  • Rectal Neoplasms / secondary*
  • Rectal Neoplasms / therapy
  • Rectum / diagnostic imaging*
  • Rectum / pathology