Silva Ines, Tome Vera, Oliveira Joao
Department of Clinical Oncology, Instituto Português de Oncologia, Lisboa, Portugal.
BMJ Case Rep. 2011 Oct 4;2011:bcr0820114692. doi: 10.1136/bcr.08.2011.4692.
Adenoid cystic carcinoma (ACC) is a rare variant of adenocarcinoma of the breast. It affects mainly minor and major salivary glands, but may also occur in many others locations such as: breast (<1% of all breast cancers), lung, trachea, cervix and Bartholin's gland. Its prognosis is excellent, contrary to the extra-mammary form. In fact, metastisation is rare (there are only seven clinical cases with metastisation described in literature and the lung is the most affected organ) and when it occurs, generally, there is no axillary node involvement. The authors present the case of a 37-year-old patient, Caucasian, premenopausal, referred to our Cancer Institute with the diagnosis of ACC of the right breast. This case was peculiar because of its multiple and fatal metastisation pattern-nodal, pulmonary, hepatic, osseous and late multifocal cerebral involvement (brain stem and cerebellum). This is the first case-report of ACC with cerebral metastisation.
腺样囊性癌(ACC)是乳腺癌腺癌的一种罕见变体。它主要影响小唾液腺和大唾液腺,但也可能发生在许多其他部位,如:乳腺(占所有乳腺癌的不到1%)、肺、气管、宫颈和巴氏腺。与乳腺外形式相反,其预后良好。事实上,转移很少见(文献中仅描述了7例有转移的临床病例,肺是最常受影响的器官),当发生转移时,通常没有腋窝淋巴结受累。作者介绍了一名37岁的白种人绝经前患者的病例,该患者因右乳腺ACC诊断转诊至我们的癌症研究所。该病例很特殊,因为其具有多种致命的转移模式——淋巴结、肺、肝、骨转移以及晚期多灶性脑转移(脑干和小脑)。这是首例有脑转移的ACC病例报告。