Segmental colonic stenosis in intestinal metastasis of breast carcinoma. A contribution to the differential diagnosis of colitis

Four years after mastectomy for a scirrhous carcinoma a 71-year-old woman developed diarrhoea. Crohn's disease was suspected. At endoscopy a stenosis of the sigmoid colon was found which could not be passed: the mucosa was normal looking. Gastrointestinal radiography revealed segmental subtotal stenoses of the colon with linitis plastica, typical for tumour-caused infiltration, as well as indentations in the small intestine by mesenteric metastases. The diagnosis was confirmed by computed tomography and, finally, operation. Chemotherapy failed to produce any regression of the colon stenoses, and the patient died from mechanical ileus. In case of a similar history and colon stenoses of uncertain aetiology the possibility of intestinal metastases should be considered in the differential diagnosis.