Moriarty John M, Xing Minzhi, Loh Christopher T
Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
J Med Case Rep. 2012 Jul 4;6:186. doi: 10.1186/1752-1947-6-186.
Sudden severe hemorrhage from locally advanced fungating breast carcinoma and its associated cutaneous lesions is rarely reported. Transcatheter arterial embolization has been used widely in the setting of intractable neoplastic hemorrhage arising from primary and metastatic tumors of the lung, liver, kidney, and gastrointestinal tract. Here, we detail the use of transcatheter arterial embolization in controlling torrential hemorrhage in a patient with advanced invasive breast cancer and multiple comorbidities.
We report the case of a 28-year-old African-American woman who presented with acute torrential hemorrhage from a high-grade invasive ductal breast carcinoma. A computed tomography scan demonstrated a 14cm mass with extensive muscle, fascial, and cutaneous invasion. Owing to the extent of invasion and multiple comorbidities, she was deemed to be unsuitable for surgical management. Selective angiography of the left internal mammary artery revealed no tumoral blush, extravasation, or pseudoaneurysm. Transcatheter arterial embolization was undertaken, and complete occlusion of the vessel was demonstrated. No further episodes of hemorrhage occurred.
Though rare, sudden severe hemorrhage from advanced breast cancer may be definitively managed by embolization alone and thus surgery may be avoided.
局部晚期溃疡性乳腺癌及其相关皮肤病变引起的突然严重出血鲜有报道。经导管动脉栓塞术已广泛应用于治疗由肺、肝、肾及胃肠道原发性和转移性肿瘤引起的顽固性肿瘤出血。在此，我们详细介绍经导管动脉栓塞术在控制一名患有晚期浸润性乳腺癌且合并多种疾病患者的大量出血中的应用。
我们报告一例28岁非裔美国女性患者，其患有高级别浸润性导管乳腺癌并出现急性大量出血。计算机断层扫描显示一个14厘米的肿块，伴有广泛的肌肉、筋膜和皮肤侵犯。由于侵犯范围广且合并多种疾病，她被认为不适合手术治疗。左乳内动脉选择性血管造影未发现肿瘤染色、造影剂外渗或假性动脉瘤。进行了经导管动脉栓塞术，显示血管完全闭塞。未再发生出血事件。
尽管罕见，但晚期乳腺癌引起的突然严重出血可仅通过栓塞术得到明确治疗，从而可避免手术。
