Sandy Saintelia
University of Medicine and Health Sciences
Title: Metastatic Breast Cancer Hidden in Plain Sight
Biography
Biography: Sandy Saintelia
Abstract
A 71-year-old female status post bilateral partial mastectomy (30years) initially presented to the hospital with abdominal pain, fatigue, headache, loss of appetite, and weight loss. Investigations revealed a hemoglobin of 6.6 mg/dl and without evidence of active bleeding. A computed tomography (CT) of abdomen and pelvis were negative for metastatic disease or new malignancies. She was managed with blood transfusion and oral iron supplements. After 4 months, she presented to the hospital with fatigue, loss of appetite, weight loss, abdominal cramping, and pain. The examination was unremarkable except for abdominal tenderness. The laboratory investigations revealed a hemoglobin of 11.6 g/dl, normal iron studies and a peripheral smear showing anisocytosis, target cells, tear drop cells and schistocytes. The CT of the abdomen and pelvis and magnetic resonance imaging (MRI) of the abdomen showed small and distal bowel obstruction. She was relieved of symptoms after surgery with the resected small bowel mass showing multifocal metastatic pleomorphic lobular carcinoma, consistent with her breast malignancies. She was advised positron emission tomography (PET) scan and aromatase inhibitors for ER + metastatic disease.