Vergier B, Trojani M, de Mascarel I, Coindre J M, Le Treut A
Department of Pathology, Fondation Bergonié, Bordeaux, France.
J Surg Oncol. 1991 Oct;48(2):112-6. doi: 10.1002/jso.2930480208.
Eight patients with breast metastases from primary tumors other than breast carcinoma were studied: 3 malignant melanomas, 2 rhabdomyosarcomas, 1 malignant mesothelioma, 1 appendiceal carcinoid, and 1 epidermoid cervical carcinoma. All had mammographic, histopathologic, and immunohistochemical examinations. The main problem was differential diagnosis from primary breast carcinoma. History of extramammary primary tumor was helpful but breast metastasis was the first clinical feature in 2 cases. Patients had noticed palpable, round, rapid growth masses which were mammographically benign. Pathologic diagnosis was difficult and immunohistochemical studies necessary, whenever the proliferation had histologic features of primary breast carcinoma or when no primary tumor was known. However, some histologic features were of value for diagnosis of metastasis: atypical histologic features for a primary breast carcinoma, a well-circumscribed tumor with multiple satellite foci, the absence of an intraductal component, and the presence of many lymphatic emboli. In adults, the most frequent types of tumors metastasizing in the breast are malignant melanoma and neuroendocrine-like tumors, especially small cell carcinoma and carcinoid. In children, rhabdomyosarcoma is the most common. Accurate diagnosis of breast metastasis is important to avoid unnecessary mastectomy and to implement an appropriate systemic therapy.
对8例源自非乳腺癌原发性肿瘤的乳腺转移瘤患者进行了研究：3例恶性黑色素瘤、2例横纹肌肉瘤、1例恶性间皮瘤、1例阑尾类癌和1例宫颈表皮样癌。所有患者均接受了乳房X线摄影、组织病理学和免疫组织化学检查。主要问题是与原发性乳腺癌进行鉴别诊断。乳腺外原发性肿瘤病史有帮助，但2例患者乳腺转移是首个临床特征。患者注意到可触及的圆形、生长迅速的肿块，乳房X线摄影显示为良性。当增殖具有原发性乳腺癌的组织学特征或未知原发性肿瘤时，病理诊断困难，免疫组织化学研究是必要的。然而，一些组织学特征对转移瘤的诊断有价值：原发性乳腺癌的非典型组织学特征、有多个卫星灶的边界清楚的肿瘤、无导管内成分以及存在许多淋巴栓子。在成人中，转移至乳腺的最常见肿瘤类型是恶性黑色素瘤和神经内分泌样肿瘤，尤其是小细胞癌和类癌。在儿童中，横纹肌肉瘤最常见。准确诊断乳腺转移瘤对于避免不必要的乳房切除术和实施适当的全身治疗很重要。
