Liu Lulu, Zhang Jingjing, Chen Mingtai, Ren Saisai, Liu Haihui, Zhang Hao
Department of Central Laboratory Department of Hematology, Affiliated Hospital of Jining Medical University, Jining, Shandong, P.R. China.
Medicine (Baltimore). 2017 Nov;96(45):e8529. doi: 10.1097/MD.0000000000008529.
Occult breast cancer (OBC) is a rare type of breast cancer without any symptoms in the breast and is often presented with initial symptoms of axillary lymph node metastasis or other metastases. The low incidence rates of OBC make it a great challenge to diagnose and cure.
Our case was a 58-year-old female affected by dizziness and fatigue for nearly a month. Blood tests revealed anemia and thrombocytopenia, and pathological results of a bone marrow biopsy confirmed the metastatic carcinoma.
It was diagnosed as an OBC based on the positive immunohistochemical staining of cytokeratin (CK) and gross cystic disease fluid protein-15 (GCDFP-15).
Doctor advised her to check whether the bone metastases existed in order to choose an appropriate treatment. It is highly regrettable that the patient gave up all treatments and left the hospital.
Recently, we conducted a telephone follow-up and received that the patient only took tramadol and other painkilling drugs to alleviate the pain caused by cancer.
The current case inferred that symptoms of anemia and thrombocytopenia should not be ignored for the diagnosis of OBC, and bone marrow biopsy is useful in reducing the rates of misdiagnosis and missed diagnosis of OBC.
隐匿性乳腺癌（OBC）是一种罕见的乳腺癌类型，乳房没有任何症状，通常以腋窝淋巴结转移或其他转移的初始症状出现。OBC的低发病率使其诊断和治疗极具挑战性。
我们的病例是一名58岁女性，近一个月来受头晕和疲劳困扰。血液检查显示贫血和血小板减少，骨髓活检的病理结果证实为转移性癌。
根据细胞角蛋白（CK）和总囊性病液蛋白-15（GCDFP-15）免疫组化染色阳性，诊断为OBC。
医生建议她检查是否存在骨转移，以便选择合适的治疗方法。非常遗憾的是，患者放弃了所有治疗并出院。
最近，我们进行了电话随访，得知患者仅服用曲马多等止痛药来缓解癌症引起的疼痛。
当前病例表明，诊断OBC时不应忽视贫血和血小板减少的症状，骨髓活检有助于降低OBC的误诊和漏诊率。
