Puglisi Maria, Varaldo Emanuela, Assalino Michela, Ansaldo Gianluca, Torre Giancarlo, Borgonovo Giacomo
University of Genova, Largo Benzi, 8. 16132 Genova, Italy.
World J Gastroenterol. 2009 Mar 21;15(11):1388-90. doi: 10.3748/wjg.15.1388.
We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later, she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis. According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.
我们报告一例乳腺小叶癌孤立性胃肠道转移病例,该病例酷似原发性肛管癌。2000年7月,一名88岁女性被诊断为浸润性小叶癌(pT1/G2/N2)。患者接受了术后放疗和激素治疗。四年后,她出现了肛管息肉样病变。该肿物被切除用于活检。免疫组化染色提示起源于乳腺。该患者选择了放疗,病变完全消退。患者在胃肠道转移首次出现后3年死亡。根据目前的文献,我们认为免疫组化特征对于支持胃肠道乳腺转移的怀疑至关重要,并且由于我们将胃肠道受累视为系统性疾病的标志,治疗应采取较温和的全身性治疗。