CASE REPORT: MULTIMODAL DIAGNOSTIC APPROACH IN METASTATIC LESION OF BREAST FROM A SIGNET-RING CELL CARCINOMA OF THE STOMACH, ROLE OF HYBRID SPECT/CT TECHNOLOGY

Abstract

This article presents a rare clinical case of metastatic lesion of breast from a signet-ring cell carcinoma of the stomach in a patient with a clinical manifestation of inflammatory (diffuse) type of right breast cancer. Studies review indicates that breast metastases from extra-mammary malignancies occur in 0,5–2% among all breast cancers and in 0,3% among gastric cancer metastases. We have summarized and collaboratively assessed the information that we have gathered: a brief history of a patient and important findings with details of mammographic, ultrasound, MR investigations and in addition, taking in account our clinic’s opportunities – relatively new hybrid method of radionuclide diagnostics single-photon emission computed tomography with computed tomography (SPECT-CT) of breast and regional lymphatic nodes. The results of the immunohistochemical analysis played the key role in diagnostics and determined the metastatic origin of breast lesion. This is notable, given the fact that gastric adenocarcinoma metastases usually occur in younger patients and have left-sided localization, in this case both age and side are atypical. We have found approximately 60 published cases of similar secondary metastatic lesions of breast in various international medical resources. Thus, this case report demonstrates the importance of multimodal diagnostic approach and collaborative work of health professionals in management of a patient with atypical results of clinical, radiological, laboratory investigations.