Pappo I, Feigin E, Uziely B, Amir G
Department of Surgery, Hebrew University, Hadassah Medical School, Jerusalem, Israel.
J Surg Oncol. 1991 Mar;46(3):211-4. doi: 10.1002/jso.2930460318.
Obstructive jaundice developed in a patient concomitantly with the diagnosis of breast carcinoma. Abdominal exploration disclosed a metastatic tumor in the head of the pancreas, the distal bile duct, and the gallbladder. A cholecystectomy and choledochojejunostomy were performed and later, because of intestinal obstruction, the patient underwent gastrojejunostomy. Pathological examination demonstrated metastatic lobular carcinoma of breast with strongly positive staining for estradiol. Additional hormonal therapy has been given to the patient since the operation. The patient is alive 16 months after the diagnosis of her disease. This case suggests that a vigorous diagnostic approach should be adopted in every jaundiced patient with metastatic breast cancer in order to exclude causes of jaundice other than diffuse metastatic involvement of the liver. Patients with extrahepatic biliary metastasis should be treated by aggressive surgical treatment, combined with systemic therapy which can offer them significant palliation and better survival.
一名患者在被诊断为乳腺癌的同时出现了梗阻性黄疸。腹部探查发现胰腺头部、胆总管远端和胆囊有转移性肿瘤。进行了胆囊切除术和胆总管空肠吻合术，后来由于肠梗阻，患者接受了胃空肠吻合术。病理检查显示为乳腺小叶转移性癌，雌二醇染色呈强阳性。自手术后，该患者接受了额外的激素治疗。该患者在疾病诊断后存活了16个月。该病例表明，对于每一位患有转移性乳腺癌的黄疸患者，都应采取积极的诊断方法，以排除除肝脏弥漫性转移累及之外的黄疸原因。肝外胆管转移的患者应接受积极的手术治疗，并结合全身治疗，这可以为他们提供显著的姑息治疗并改善生存状况。
