Gastric Linitis Plastica and Peritoneal Carcinomatosis as FirstManifestations of Occult Breast Carcinoma: A Case Report andLiterature Review

Gastric linitis plastica is a diffuse involvement of the stomach walls by neoplastic cells. It represents about 3–19% of primitive gastricadenocarcinomas, but it can also be the manifestation of a metastatic disease. Breast cancer is the most frequent malignancy inwomen, and the metastatic spread to the stomach occurs in less than 10% of the cases. We present an unusual case of gastriclinitis plastica and peritoneal carcinomatosis as manifestations of an occult breast cancer in a 53-year-old woman. Imaging andendoscopic evaluation were not able to discriminate a primary from a secondary gastric lesion. The histological evaluationexcluded the diagnosis of a primary gastric neoplasia. The IHC profile was consistent with the diagnosis of metastases from thebreast cancer. Due to the hormonal receptors’positivity, we started therapy with fulvestrant (500 mg, day 0, 14, and 28 andevery 28 days thereafter by intramuscular injection). After 20 months, the same therapy is still ongoing and well tolerated, whilethe patient is in good condition with improvement of the dysphagia. Almost 2 years after the diagnosis of linitis plastica, theprimitive breast lesion is still occult.