IntroductionBreast cancer remains the most common cancer and one of the leading causes of death in women 1,2. Invasive lobular carcinoma represents approximately 5% to 15% of invasive breast carcinomas, with an incidence between 1% and 20% in the literature, increasing in the last 20 years, possibly related to hormone replacement therapy, compared to ductal carcinoma, which remains stable3. At diagnosis, from 3% to 12% of patients are metastatic, and 30% to 80% of patients experience distant metastatic progression after surgery, chemotherapy, hormone therapy, and radiotherapy 4,5. The preferred metastatic sites are the lymph nodes, skeleton, gynecological organs, and peritoneum. Extrahepatic digestive metastases remain rare, with incidences reported in the literature between 6% and 18%, sometimes synchronous with the diagnosis of the primary lesion 6, and sometimes appearing years after the diagnosis of the breast lesion7–9. The stomach is more frequently affected compared to the colon (6-18% versus 8-12%) 10. We present the case of a female patient with metastatic infiltrating lobular carcinoma, who developed unexpected secondary gastric metastases 20 years after the management of the primary tumor. To the best of our knowledge, this is the first report on the identification of such lesions by [18F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Other metastatic sites, particularly bone, were controlled under treatment. Notably, the patient had a history of gastroesophageal reflux and histologically confirmed Helicobacter pylori -negative gastritis, which might have misled the diagnosis toward a benign condition.