Yordanov Y, Dimitrova P
Akush Ginekol (Sofiia). 2015;54(1):38-43.
The breast is an extremely rare target organ for metastasis of extramammary neoplasms. The occurence varies between 1.7% to 6.6% in autopsies; between 1.2% and 2% in clinical cases; and around 2.7% in sputum series. In accordance with the primary tumor localization, it is more common to find metastases of lymphoma, melanoma, rhabdomyosarcoma, tumors of the lung and ovarian tumors. Breast metastasis of the uterine cervix is a very seldomly found. According to the published literature so far there have been around 30 documented cases with such pathology. This study presents the case of a 48-year-old female with a squamous cell carcinoma of the uterine cervix, which was histologically verified in 2010. Three years after the initial tumor diagnosis, radiotherapy and chemotherapy, the patient was found to have a cystic tumor formation in one of her breasts. The formation was painful to pressure. Quadrantectomy with an open bisopsy was performed to the patient. Histological and immunohistochemical diagnosis rejected primary squamous cell carcinoma of the breast. The differential diagnosis of metastatic lesions in the breast is problematic and requires careful clinical history, immunohistochemical study and multidisciplinary approach in the management. Mammary metastases are a bad predictor and they serve as an indicator of generalized dissemination of the primary tumor process.
乳腺是乳腺外肿瘤转移极为罕见的靶器官。尸检中其发生率在1.7%至6.6%之间;临床病例中在1.2%至2%之间;痰液系列中约为2.7%。根据原发肿瘤的部位,淋巴瘤、黑色素瘤、横纹肌肉瘤、肺癌及卵巢肿瘤的转移更为常见。子宫颈癌的乳腺转移非常罕见。根据目前已发表的文献,此类病理情况记录在案的病例约有30例。本研究报告了一例48岁女性子宫颈鳞状细胞癌病例,该病例于2010年经组织学证实。在最初诊断肿瘤、放疗及化疗三年后,患者一侧乳房发现有囊性肿瘤形成,按压时有疼痛感。对该患者实施了象限切除及开放活检。组织学和免疫组化诊断排除了原发性乳腺鳞状细胞癌。乳腺转移瘤的鉴别诊断存在问题,需要仔细询问临床病史、进行免疫组化研究并采用多学科方法进行处理。乳腺转移是一个不良预后指标,提示原发肿瘤已发生全身播散。