Hydrothermal alteration related to Sb-Au mineralization is widespread in the Variscan Armorican Massif, but mineral replacement reactions are not well characterized, in particular the hydrothermal breakdown of ilmenite-titanohematite. Based on petrography, electron probe micro-analyzer and laser ablation-inductively coupled plasma-mass spectrometer analyses, we document mineralogical change at rock- and mineral-scale and the redistribution of Sb and others trace elements during the recrystallization of ilmenite-titanohematite to hydrothermal rutile. Hydrothermal alteration is mainly potassic with associated carbonation. The replacement mechanism is interpreted to be an interface-coupled dissolution-reprecipitation process. Results show that Mn, Zn, Co, Ni, Sn, Mo and U are released during hydrothermal alteration, whereas Sb and W are incorporated in newly-formed hydrothermal rutile from the hydrothermal fluid. Furthermore, the concentration of Sb evolves through time suggesting a change in fluid composition likely related to an enrichment of fluid in Sb during rutile crystallization. Considering that Fe-Ti oxides breakdown during hydrothermal alteration is common within epithermal and mesothermal/orogenic Au-Sb mineralizing systems, results report in this study yield important constraints about metal mobility and exchanges in hydrothermal gold systems.