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Mullally WJ, O'Súilleabháin CB, Brady C, et al. Vinorelbine induced perforation of a metastatic gastric lesion. Ir J Med Sci. 2016;186(3):571-575doi: 10.1007/s11845-016-1536-1.
Mullally, W. J., O'Súilleabháin, C. B., Brady, C., & O'Reilly, S. (2017). Vinorelbine induced perforation of a metastatic gastric lesion. Irish journal of medical science, 186(3), 571-575. https://doi.org/10.1007/s11845-016-1536-1
Mullally, W J, et al. "Vinorelbine induced perforation of a metastatic gastric lesion." Irish journal of medical science vol. 186,3 (2017): 571-575. doi: https://doi.org/10.1007/s11845-016-1536-1
Mullally WJ, O'Súilleabháin CB, Brady C, O'Reilly S. Vinorelbine induced perforation of a metastatic gastric lesion. Ir J Med Sci. 2017 Aug;186(3):571-575. doi: 10.1007/s11845-016-1536-1. Epub 2016 Dec 30. PMID: 28039597; PMCID: PMC5550518.
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Ir J Med Sci. 2017 Aug;186(3):571-575. doi: 10.1007/s11845-016-1536-1. Epub 2016 Dec 30.

Vinorelbine induced perforation of a metastatic gastric lesion.

Irish journal of medical science

W J Mullally, C B O'Súilleabháin, C Brady, S O'Reilly

Affiliations

  1. Department of Medical Oncology, Cork University Hospital, Wilton Rd, Cork, Ireland. [email protected].
  2. , Kells, Bishopstown Avenue West, Model Farm Rd, Cork, Ireland. [email protected].
  3. Hepatobiliary Pancreas Unit, Mercy University Hospital, Grenville Place, Cork, Ireland.
  4. Department of Medical Oncology, Cork University Hospital, Wilton Rd, Cork, Ireland.

PMID: 28039597 PMCID: PMC5550518 DOI: 10.1007/s11845-016-1536-1

Abstract

BACKGROUND: Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637-641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review.

METHODS: A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler's sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma.

RESULTS: Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071-1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761-1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma.

CONCLUSION: This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted in gastric perforation. Five years after gastric perforation she resumed palliative chemotherapy after progression on sequential hormonal therapies.

Keywords: Gastric perforation; Gastric side effects; Metastatic breast cancer; Vinorelbine

References

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