Luo Xin-Yu, Wang Jue, Zhao Jia, Chen Rui, Zha Xiao-Ming
Department of Breast Disease, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.
Oncol Lett. 2017 Jul;14(1):31-34. doi: 10.3892/ol.2017.6158. Epub 2017 May 11.
Breast cancer has the highest rate of incidence among all types of cancer in women. Only ~0.43% of breast malignancies occur as a result of metastatic lesions from extramammary tumors. The present study reports an extremely rare case of transverse colon cancer metastasizing to the bilateral ovaries and the left breast. The patient was a 47-year old female, who had a lump in the left breast without axillary lymphadenopathy. Specimens obtained by core needle biopsy were submitted for hematoxylin and eosin examination, and results revealed that the lump was a poorly differentiated adenocarcinoma. Since the patient had elevated levels of the carcinoembryonic antigen and a medical history of a Krukenberg tumor metastasized from colon cancer, immunohistochemical examinations were applied. Results identified that caudal-related homeobox protein 2 and cytokeratin 20 were positively stained, whilst cytokeratin 7 was negatively stained. Therefore, this patient was diagnosed as having colon cancer that had metastasized to the bilateral ovaries and the left breast. As the life expectancy of patients with cancer is increasing, types of metastases that used to be seen as rare are increasingly becoming more common. For clinicians, diagnosis should be cautious, and differential diagnosis should always be kept in mind.
乳腺癌在女性所有类型癌症中的发病率最高。仅有约0.43%的乳腺恶性肿瘤是由乳腺外肿瘤的转移灶引起的。本研究报告了1例极为罕见的横结肠癌转移至双侧卵巢及左侧乳腺的病例。患者为一名47岁女性,左侧乳腺有一肿块,无腋窝淋巴结肿大。通过粗针活检获取的标本进行苏木精-伊红染色检查,结果显示该肿块为低分化腺癌。由于患者癌胚抗原水平升高且有结肠癌转移所致克鲁肯伯格瘤病史,故进行了免疫组化检查。结果显示尾型相关同源盒蛋白2和细胞角蛋白20呈阳性染色,而细胞角蛋白7呈阴性染色。因此,该患者被诊断为结肠癌转移至双侧卵巢及左侧乳腺。随着癌症患者预期寿命的增加,过去被视为罕见的转移类型正变得越来越常见。对于临床医生而言,诊断应谨慎,始终要牢记鉴别诊断。