Anatomia Patologica, Ospedale di Sestri Levante, Via Terzi 43/a, 16039 Sestri Levante (Genoa), Italy.
Updates Surg. 2011 Jun;63(2):129-33. doi: 10.1007/s13304-011-0047-x. Epub 2011 Feb 1.
Intra-abdominal metastases from breast carcinomas are rarely reported in the literature. Least are those originating from occult breast primary. We report, one case of pancreatic metastasis and one case of metastatic infiltration of the colonic wall, both by occult lobular breast carcinoma. The first patient underwent pancreaticoduodenectomy for obstructive jaundice, with unexpected histological finding of infiltration of distal bile duct, pancreatic gland, portal vein and retroperitoneal soft tissue by lobular carcinoma of the breast. The second patient complained of diffuse abdominal pain associated with constipation and rectal bleeding and underwent endoscopic biopsy of three intestinal strictures, revealing metastatic lobular carcinoma with signet-ring cell morphology. In both cases, a subsequent complete diagnostic work-up demonstrated asymptomatic multiple breast nodules, diagnosed as lobular carcinoma by fine needle aspiration cytology.
文献中鲜有乳腺癌腹腔内转移的报道，而由隐匿性乳腺癌原发灶引起的转移则更为罕见。我们报告了两例隐匿性小叶性乳腺癌引起的病例，一例为胰腺转移，另一例为结肠壁转移性浸润。第一例患者因梗阻性黄疸行胰十二指肠切除术，意外发现远端胆管、胰腺、门静脉和腹膜后软组织浸润性小叶性乳腺癌。第二例患者诉弥漫性腹痛伴便秘和直肠出血，行 3 处肠狭窄内镜活检，发现转移性小叶性乳腺癌伴印戒细胞形态。在这两例患者中，随后的全面诊断检查显示无症状的多发性乳腺结节，经细针抽吸细胞学诊断为小叶性乳腺癌。
