Makris Georgios-Marios, Marinelis Alexandros, Battista Marco-Johannes, Chrelias Charalampos, Papantoniou Nikolaos
Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece; Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece.
Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece.
Int J Surg Case Rep. 2017;31:106-108. doi: 10.1016/j.ijscr.2016.12.022. Epub 2016 Dec 30.
Differentiating between primary and secondary ovarian cancer can be a difficult task. In hereditary conditions breast malignancies and primary ovarian cancer often coexist.
We present a 45-year-old patient with an ovarian mass two years after the diagnosis of a lobular, triple negative breast carcinoma. There was concern whether the lesion represented a metachronous ovarian cancer or a metastasis of the lobular carcinoma. The final histological examination showed a metastatic lesion, deriving from the lobular breast carcinoma, as evidenced by the immunohistochemical profile; nevertheless, there were changes in hormonal receptor expression in the metastatic lesion compared to the primary, triple negative tumor. The patient underwent genetic testing for BRCA1 and BRCA2 mutations and was negative. In the adjuvant setting the patient received 6 cycles of chemotherapy with carboplatin and paclitaxel; eighteen months later, the patient remains without disease recurrence.
This case report highlights the role of imaging, histology and predominantly immunohistochemistry as valuable tools in the assessment of ambiguous ovarian lesions after breast cancer.
区分原发性和继发性卵巢癌可能是一项艰巨的任务。在遗传性疾病中，乳腺恶性肿瘤和原发性卵巢癌常同时存在。
我们报告一名45岁患者，在诊断为小叶三阴性乳腺癌两年后发现卵巢肿块。人们担心该病变是异时性卵巢癌还是小叶癌的转移灶。最终组织学检查显示为源自小叶乳腺癌的转移灶，免疫组化结果证实了这一点；然而，与原发性三阴性肿瘤相比，转移灶中的激素受体表达发生了变化。患者接受了BRCA1和BRCA2基因突变的基因检测，结果为阴性。在辅助治疗中，患者接受了6个周期的卡铂和紫杉醇化疗；18个月后，患者无疾病复发。
本病例报告强调了影像学、组织学，尤其是免疫组化在评估乳腺癌后模棱两可的卵巢病变中的重要作用。
