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INTRODUCTION: Invasive lobular cancer (ILC) is the second most common type of a heterogeneous group of different histological
types of invasive breast carcinoma. Breast cancer can metastatize anywhere, the most common sites are bones,
liver, lungs and brain. Gastrointestinal tract (GI) metastases observed in autopsy studies account for about 6% to 18%
of the overall metastases from breast cancer.
OBJECTIVE: We describe a 54-year old woman with recurrent ILC in the contralateral breast. She underwent right mastectomy
16 years before. After symptomatic presentation a duodenal invasion was found and subjected to diagnostic scrutiny
(FDG PET/CT, diagnostic CT, MR, EGDS). In particular, we analyse if FDG PET/CT is enough accurate in the
restaging of the patient. A review of our database and of the literature of similar cases were made.
RESULTS: In this patient CT and RM were suspicious for a slow developing process of the duodenum but FDG PET/CT
did not show pathological uptake in the affected duodenal tract. A highly intense focus was described in a cervical lymph
node, that there isn’t metastatic lesion, whereas the recurrent breast lesion had only slight increased glycolytic activity.
CONCLUSION: Metastatic lobular carcinoma of the breast is a rare entity with a heterogeneous range of clinical presentations.
Detection of eventual gastrointestinal metastases are complicated to assess. ILC has various scale of glycolytic activity
both in the primary lesion as well in the metastatic foci. When the level of suspicion is high and there is no uptake
of FDG, further investigations are necessary.