Işçi H, Güdücü N, Basgul A Y, Aydinli K, Calay Z, Dünder I
Department of Obstetrics and Gynecology, Istanbul Bilim University, School of Medicine, Usküdar, Istanbul.
Eur J Gynaecol Oncol. 2011;32(5):560-2.
Metastasis of extragenital neoplasms to the uterus is extremely rare. Lobular breast cancers metastasize to the uterus more than ductal carcinomas, but they metastasize as tiny nodules that can be missed with the standard diagnostic workup. Uterine involvement by a metastatic tumor is usually a manifestation of end-stage disease; patients are reported to die within weeks to months. Therefore surgery is not recommended. Here we report a case of lobular breast cancer metastasizing to a leiomyoma in a patient using letrozole. Our patient was submitted to surgery because the leiomyoma had grown to the level of the xiphoid process. She is alive one year after the operation. In conclusion growth of leiomyomas under aromatase inhibitors should be considered as a sign of metastases and surgery can be planned in selected cases.
生殖器外肿瘤转移至子宫极为罕见。小叶型乳腺癌比导管癌更易转移至子宫，但转移时为微小结节，在标准诊断检查中可能被漏诊。转移性肿瘤累及子宫通常是终末期疾病的表现；据报道患者会在数周内至数月内死亡。因此不建议进行手术。在此我们报告一例使用来曲唑的患者，小叶型乳腺癌转移至平滑肌瘤。我们的患者接受了手术，因为平滑肌瘤已生长至剑突水平。术后一年她仍存活。总之，芳香化酶抑制剂治疗期间平滑肌瘤的生长应被视为转移的征象，在特定病例中可考虑进行手术。
