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乳腺癌转移至胆囊。

Metastasis of the gallbladder from the breast cancer.

作者信息

Fleres Francesco, Rossitto Maurizio, Foti Agata, Macrì Antonio, Cucinotta Eugenio

出版信息

Ann Ital Chir. 2014 Dec 29;85(ePub):S2239253X14023470.

Abstract

AIM

Metastatic lesions of the gallbladder are an infrequent clinical condition. The metastatic lesions of gallbladder from primary breast tumors are rarely described in literature.

MATERIAL OF STUDY

We report a case of an 83-year-old woman who underwent cholecystectomy for cholelithiasis by video laparoscopy (VL), and in whom a metastatic lesion was detected at the histological examination of surgical specimen. For this reason, the patient was subjected to diagnostic-instrumental investigation with the aim of detecting the primary tumor, which showed the presence of infiltrating lobular carcinoma, pleomorphic variety, in the upper outer quadrant of the right breast.

DISCUSSION

Breast cancer and in particular the histological type "ductal infiltrating" is frequently associated with locoregional and distant metastases, the latter especially to bones, liver, lungs and central nervous system. An analysis of literature was conducted on secondary lesions of the gallbladder from breast cancer that has allowed us to confirm the rarity of this disease only described in 18 patients: 12 from infiltrating lobular, 1 ductal origin and 2 mixed ductal and lobular infiltrating.

CONCLUSIONS

The most frequent tumor histology associated with the above-mentioned metastatic localization is the metastatic infiltrating lobular carcinoma. Clinically speaking, it is difficult to suspect a metastatic localization from primary breast cancer in the gallbladder, but it is necessary to be well aware of the possibility of metastasis and to bear this in mind during the follow-up of patients with breast cancer. Although cholecystectomy is regarded as a palliative treatment in patients with metastasis in the gallbladder from breast cancer, it is intead recommended in symptomatic cases.

摘要

目的

胆囊转移瘤是一种临床罕见病症。原发性乳腺肿瘤转移至胆囊的病例在文献中鲜有描述。

研究材料

我们报告一例83岁女性患者,因胆结石接受了视频腹腔镜胆囊切除术(VL),在手术标本的组织学检查中发现了转移瘤。因此,对该患者进行了诊断性仪器检查以检测原发肿瘤,结果显示右乳外上象限存在浸润性小叶癌,多形性变种。

讨论

乳腺癌,尤其是“导管浸润性”组织学类型,常伴有局部和远处转移,后者尤其转移至骨骼、肝脏、肺和中枢神经系统。我们对乳腺癌转移至胆囊的继发性病变进行了文献分析,结果证实这种疾病很罕见,仅在18例患者中被描述过:12例来自浸润性小叶癌,1例起源于导管癌,2例为导管和小叶浸润混合型。

结论

与上述转移部位相关的最常见肿瘤组织学类型是转移性浸润性小叶癌。从临床角度而言,很难怀疑胆囊存在原发性乳腺癌转移,但必须充分意识到转移的可能性,并在乳腺癌患者的随访过程中牢记这一点。虽然胆囊切除术在乳腺癌转移至胆囊的患者中被视为一种姑息性治疗,但对于有症状的病例反而推荐进行该手术。

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