Department of Surgery, Hamanomachi Hospital, 3-5-27 Maizuru, Chuo-ku, Fukuoka, 810-8539, Japan.
Surg Today. 2011 Apr;41(4):542-5. doi: 10.1007/s00595-009-4305-1. Epub 2011 Mar 23.
A 48-year-old woman developed a mobile abdominal mass in the course of treatment for recurrent breast cancer. Imaging studies indicated linitis plastica of the colon. She underwent surgery because of the stenosis of the transverse colon. An examination of the resected specimen revealed a segmental stricture, thickening of the entire wall, and a granular mucosa resembling cobblestones. Microscopic findings of the colon lesion were very similar to those of her primary, invasive lobular carcinoma of the breast. Atypical cells showed immunoreactivity for cytokeratin-7, but not for cytokeratin-20. These findings suggested that the lesion of the colon was a colonic metastasis of breast cancer. Metastatic gastrointestinal diseases originating from breast carcinoma are unusual, and colonic metastases are especially rare. Although colon cancer may occur in patients with a history of breast cancer, metastatic colon cancer should be suspected if linitis plastica is detected.
一位 48 岁女性在接受复发性乳腺癌治疗的过程中出现移动性腹部肿块。影像学研究提示结肠皮革状癌。由于横结肠狭窄,她接受了手术。对切除标本的检查显示节段性狭窄、全壁增厚和类似鹅卵石的颗粒状黏膜。结肠病变的显微镜检查结果与她的原发性浸润性小叶癌非常相似。非典型细胞对细胞角蛋白-7呈免疫反应性,但对细胞角蛋白-20无反应性。这些发现表明结肠病变是乳腺癌的结肠转移。源自乳腺癌的胃肠道转移性疾病并不常见,结肠转移尤其罕见。虽然乳腺癌患者可能会发生结肠癌,但如果发现皮革状癌,则应怀疑转移性结肠癌。