Benfiguig A, Anciaux M L, Eugène C I, Benkémoun G, Etienne J C
Unité de Gastroentérologie, Centre Hospitalier Intercommunal, Poissy.
Ann Gastroenterol Hepatol (Paris). 1992 Jun-Sep;28(4):175-7.
The authors report the case of a 75-year-old female patient who presented with a deterioration in her general health and epigastralgia 30 years after mastectomy for cancer. The findings of an exhaustive assessment was normal apart from an inflammatory syndrome with hyperleukocytosis and subcardial ulceration, which gave negative endoscopic biopsies. The patient underwent surgery and the total gastrectomy ablation demonstrated that this was a metastasis of a mammary adenoma. Follow-up for two years did not reveal any recurrence. The mean time to the development of gastric metastases of breast cancers is 2 to 4 years. Life expectancy appears to be greater the longer this latency time. The usual blood-borne spread explains why endoscopic biopsies may be falsely reassuring, since the first layers to be affected are the serous and submucosal layers. Localized forms may simulate ulcers; nodular forms are more appropriate for curative surgery than the more common infiltrating forms (which resemble linitis). These infiltrating forms are often combined with peritoneal damage and/or extradigestive metastases.
作者报告了一例75岁女性患者的病例,该患者在因癌症行乳房切除术后30年出现全身健康状况恶化和上腹部疼痛。详尽评估的结果除了伴有白细胞增多的炎症综合征和心下溃疡外均正常,内镜活检结果为阴性。患者接受了手术,全胃切除显示这是一例乳腺腺瘤转移。随访两年未发现任何复发。乳腺癌发生胃转移的平均时间为2至4年。这种潜伏期越长,预期寿命似乎越长。常见的血行转移解释了为什么内镜活检可能会给出错误的安心结果,因为首先受影响的是浆膜层和黏膜下层。局限性病变可能类似溃疡;结节性病变比更常见的浸润性病变(类似皮革胃)更适合进行根治性手术。这些浸润性病变常伴有腹膜损害和/或消化道外转移。