# Gastrointestinal Bleeding Unmasking Gastric Metastases From a Primary Breast Malignancy: A Case Report

## TL;DR

A rare case of breast cancer metastasis to the stomach causing gastrointestinal bleeding is reported, highlighting the need for thorough investigation in similar cases.

## Contribution

This case report adds to the limited literature on gastric metastases from breast cancer and emphasizes the importance of biopsy for diagnosis.

## Key findings

- A 74-year-old woman with a history of breast cancer presented with melena due to gastric metastasis.
- Histologic analysis confirmed metastatic breast cancer in the stomach.
- Anticoagulation may have worsened the bleeding, necessitating endoscopic evaluation.

## Abstract

Metastases to the gastrointestinal tract from primary breast malignancies are rare. Acute gastrointestinal bleeding in patients with history of breast cancer, however, should raise clinical suspicion and warrant further investigation for metastatic disease involving the gastrointestinal tract. We report a case of a 74-year-old female with metastatic breast cancer and provoked thromboembolic events on anticoagulation, who was found to have poorly cohesive gastric carcinoma with immunohistochemistry consistent with primary breast malignancy, after presenting with new-onset melena. Use of anticoagulation may have exacerbated bleeding prompting endoscopic examination. Biopsy and histologic assessment are needed for definitive diagnosis and timely management.