Frontiers in oncology · 2026
Case Report: Not all signet rings are of gastric origin: a case of lobular breast carcinoma metastatic to the stomach.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sofianidi Amalia A, Papadimitris Constantinos, Papanikolaou Maria, Lakiotaki Eleftheria, Korkolopoulou Penelope, Dimopoulos Meletios-Athanasios, Kaparelou Maria
Аннотация
BACKGROUND: Invasive lobular carcinoma (ILC) is a distinct breast cancer subtype with a characteristic infiltrative growth pattern linked to loss of E-cadherin. GI metastases may clinically and histologically mimic primary GI malignancies, creating significant diagnostic pitfalls.
CASE PRESENTATION: A 52-year-old woman with de novo metastatic, grade 1, luminal A ILC (ER+/PR+, HER2 0; Ki-67 5%) diagnosed in 2022 achieved durable disease control with systemic therapy and maintenance ribociclib plus ovarian suppression. In late 2025, she developed progressive epigastric discomfort and rising tumour markers. Gastroduodenal endoscopy demonstrated erythematous gastric mucosa with focal whitish areas. Biopsies showed diffuse-type adenocarcinoma with signet ring morphology, initially interpreted as primary gastric cancer. Expert review with comparative pathology and extended immunohistochemistry demonstrated GATA3 and TRPS1 positivity, strong ER/PR expression, CDX2 negativity, and loss of E-cadherin, supporting gastric metastasis from ILC. Despite no clear radiologic progression on CT, symptomatic gastric involvement and weight loss prompted initiation of second-line weekly paclitaxel.
CONCLUSION: Signet ring morphology in gastric biopsies is not pathognomonic for primary gastric carcinoma. In patients with current or prior ILC, an IHC panel incorporating breast-lineage markers (e.g., GATA3, TRPS1) and GI markers (e.g., CDX2, CK20), alongside E-cadherin status, is pivotal to avoid misdiagnosis, inappropriate surgery, and delay of systemic therapy.
CASE PRESENTATION: A 52-year-old woman with de novo metastatic, grade 1, luminal A ILC (ER+/PR+, HER2 0; Ki-67 5%) diagnosed in 2022 achieved durable disease control with systemic therapy and maintenance ribociclib plus ovarian suppression. In late 2025, she developed progressive epigastric discomfort and rising tumour markers. Gastroduodenal endoscopy demonstrated erythematous gastric mucosa with focal whitish areas. Biopsies showed diffuse-type adenocarcinoma with signet ring morphology, initially interpreted as primary gastric cancer. Expert review with comparative pathology and extended immunohistochemistry demonstrated GATA3 and TRPS1 positivity, strong ER/PR expression, CDX2 negativity, and loss of E-cadherin, supporting gastric metastasis from ILC. Despite no clear radiologic progression on CT, symptomatic gastric involvement and weight loss prompted initiation of second-line weekly paclitaxel.
CONCLUSION: Signet ring morphology in gastric biopsies is not pathognomonic for primary gastric carcinoma. In patients with current or prior ILC, an IHC panel incorporating breast-lineage markers (e.g., GATA3, TRPS1) and GI markers (e.g., CDX2, CK20), alongside E-cadherin status, is pivotal to avoid misdiagnosis, inappropriate surgery, and delay of systemic therapy.