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Gastric outlet obstruction as the presenting manifestation of metastatic lobular breast carcinoma

✍ Scribed by Hien Nguyen; Connie Le; Hanh Nguyen; Arman Moshyedi


Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
125 KB
Volume
4
Category
Article
ISSN
1553-5592

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✦ Synopsis


Gastric outlet obstruction (GOO) is frequently a diagnostic dilemma as malignancies have surpassed benign diseases as etiologies of GOO. 1,2 A case is presented of a previously healthy patient with persistent vomiting who was sequentially diagnosed with peptic ulcer disease (PUD), pancreatitis, and cholecystitis. Unfortunately, the diagnostic workup was less straightforward than initially suspected, as she was eventually diagnosed with a malignant GOO.

To the best of our knowledge, this is the second case in which GOO was the presenting manifestation of a previously undiagnosed metastatic lobular breast carcinoma. 1 Although gastrointestinal involvement may be a late manifestation of metastatic breast carcinoma that almost always follows after spread to other sites, this case illustrates GOO as a presenting manifestation. 3 Perhaps the most salient teaching point, consistent with recent literature, is that endoscopic biopsies in the workup of malignant GOO are often misleading and delay diagnosis. 4