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148 Unusual localizations of metastasis from lobular breast carcinoma: a case report
  1. Y Fertani,
  2. M Bouhani,
  3. M Slimane,
  4. I Houissa,
  5. R Chargui and
  6. K Rahal
  1. Surgical oncology department of salah azaiez institute, Tunisia


Introduction Pancreatic metastasis from other malignant tumor is a rare event and represent less than 5% of all pancreatic malignancies. Most common metastases arise from epithelial carcinoma such as melanoma, renal, pulmonary then lobular breast carcinoma. We report a unique case of pancreatic metastasis of myxoid breast carcinoma that occurred in a patient treated for lobular breast carcinoma 27 years ago.

Case Report We report a case of 70-year-old women with a history of lobular carcinoma of the left breast with positive hormone receptors treated in 1997. She developed distant cutaneous metastasis in the thigh and lomboaortic lymph node after 21 years of total remission.She receiver chemotherapy and hormonotherapy.

She presented to our department in June 2020 for obstructive jaundice evolving for 3 months. The delay was explained by the pandemic situation of COVID 19.

The clinical exam founded a severely icteric patient with hitching lesions. The breast exam was normal with the stability of the thigh cutaneous lesion. Ca15–3 was 30UI/L and CA19.9 was 57 UI/L. MRI with cholangiography demonstrated common bile duct dilatation upstreaming of suspect mass in the head of the pancreas.

A needle biopsy of the pancreatic lesion revealed a metastatic ER/RP +, negative HER2Neu myxoid breast carcinoma.

She underwent endoscopic biliary stent and a multidisciplinary decision was to pursue chemotherapy and hormonotherapy.

Conclusion Pancreatic metastasis is a rare event that should be considered in patients with a history of breast carcinoma and obstructive jaundice. Treatment is controversial with some authors suggesting dudenopancreatectomy in patients with controled distant disease

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