Rajan Ss, Saeed M, Mestrah M
Leeds General Infirmary, Leeds.
Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK.
J Surg Case Rep. 2012 May 1;2012(5):12. doi: 10.1093/jscr/2012.5.12.
Gastrointestinal metastasis of the breast cancer is rare and its management varies significantly from that of a primary bowel cancer. We report a case of invasive ductal cancer metastasizing to the rectum and masquerading as a rectal primary. A 60 year old caucasian woman presented with fresh rectal bleeding nine years after treatment of her primary breast cancer. The investigations revealed features suggestive of primary rectal malignancy and was managed accordingly. However, the surgical histopathology revealed poorly differentiated metastatic adenocarcinoma and the immunohistochemical evaluation confirmed origin from a breast primary. She had an uneventful post-operative recovery and remains disease free thus far. The continuing advancement in the management of breast cancer patients with resulting increase in the overall survival will lead to such unusual metastatic presentations. Hence, the awareness, identification and differentiation of such rare metastatic presentation are important in order to manage the patients appropriately in the future.
乳腺癌的胃肠道转移罕见，其治疗方法与原发性肠癌有很大差异。我们报告一例浸润性导管癌转移至直肠并伪装成原发性直肠癌的病例。一名60岁的白人女性在原发性乳腺癌治疗9年后出现新鲜直肠出血。检查显示有提示原发性直肠恶性肿瘤的特征，并据此进行了治疗。然而，手术组织病理学显示为低分化转移性腺癌，免疫组化评估证实起源于乳腺原发性肿瘤。她术后恢复顺利，迄今为止仍无疾病复发。随着乳腺癌患者治疗的不断进步，总体生存率提高，将导致此类不寻常的转移表现。因此，认识、识别和区分这种罕见的转移表现对于未来恰当地治疗患者很重要。
