Division of Infectious Diseases in Obstetrics and Gynaecology, 1st Department of Gynaecology and Obstetrics, Ludwig-Maximilians-University Munich, Campus Innenstadt, Maistrasse 11, 80337, Munich, Germany.
Arch Gynecol Obstet. 2011 Mar;283 Suppl 1:93-5. doi: 10.1007/s00404-011-1843-8. Epub 2011 Feb 4.
Although breast cancer is a major health problem worldwide, metastatic disease to the lower genital tract remains to be a rare event.
A 64-year old woman was admitted to our hospital due to newly diagnosed ascites and peripheral edema. A computer tomography had shown peritoneal carcinosis but no clear evidence of an intraabdominal mass. CA 12-5 levels were elevated. Physical examination of the breast did not show any abnormal findings, except for the fact that the patient was post bilateral breast augmentation in 1999. The peritoneal carcinosis was thought to originate from the ovaries or the endometrium and therefore the patient underwent a laparotomy with hysterectomy, bilateral salpingoovariectomy and omentectomy. Histological findings revealed a low differentiated adenocarcinoma, most likely originating from primary breast cancer. A bilateral mammography was suspicious of a tumour in the left breast which was confirmed in a second surgery. Histology showed a moderately differentiated invasive-lobular breast cancer.
To our knowledge, this is the first report about metastasis to the lower genital tract on initial presentation of an invasive-lobular carcinoma. In the differential diagnosis of peritoneal carcinosis, metastases of an invasive-lobular carcinoma should be considered.
尽管乳腺癌是全球范围内的一个主要健康问题，但转移性疾病到下生殖道仍然是一种罕见的事件。
一位 64 岁的女性因新诊断的腹水和外周水肿而入院。计算机断层扫描显示腹膜癌，但没有明确的腹腔内肿块证据。CA12-5 水平升高。乳房的体格检查除了患者在 1999 年进行过双侧乳房隆乳外，没有发现任何异常发现。腹膜癌被认为起源于卵巢或子宫内膜，因此患者接受了剖腹手术，包括子宫切除术、双侧输卵管卵巢切除术和网膜切除术。组织学检查显示低分化腺癌，最有可能来源于原发性乳腺癌。双侧乳房 X 线摄影对左侧乳房的肿瘤有怀疑，并在第二次手术中得到证实。组织学显示为中度分化浸润性小叶乳腺癌。
据我们所知，这是首例浸润性小叶癌首发时转移至下生殖道的报告。在腹膜癌的鉴别诊断中，应考虑浸润性小叶癌的转移。
