Froehlich Karolin, Stensheim Hanne, Markert Udo R, Turowski Gitta
Department of Obstetrics, Placenta Lab, University Hospital Jena, Jena, Germany.
Department of Oncology, Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway.
APMIS. 2018 May;126(5):448-452. doi: 10.1111/apm.12827. Epub 2018 Apr 17.
Breast cancer is one of the most common malignancies diagnosed in pregnancy. Although the tumor is often detected at an advanced stage, placental metastases are rare. Here, we describe the case of a woman with breast cancer recurrence during pregnancy and subsequent metastases. The focus of this study is the large amount of placenta metastases, which have been analyzed immunohistochemically. Staining with trophoblast markers (placenta alkaline phosphatase, beta human chorionic gonadotropin and human placental lactogen) showed the strict localization of metastases in the intervillous space without invasion into fetal tissue. They have a large spheroidal shape and are free of blood vessels. Staining with Ki-67 revealed an outer proliferative shell and inner necrotic core. At week 28, a healthy newborn was born by elective cesarean section. A few weeks later, after surgery and FEC60 (fluorouracil, epirubicin, cyclophosphamide) cycles, the patient died. Breast cancer metastases in the placenta are rarely described. The special immunological environment in pregnancy may influence phenotype, growth, and behavior of tumor and metastases.
乳腺癌是孕期诊断出的最常见恶性肿瘤之一。尽管肿瘤常于晚期被发现，但胎盘转移罕见。在此，我们描述一例孕期乳腺癌复发及随后发生转移的病例。本研究的重点是大量胎盘转移灶，已对其进行免疫组化分析。用滋养层标志物（胎盘碱性磷酸酶、β-人绒毛膜促性腺激素和人胎盘催乳素）染色显示转移灶严格局限于绒毛间隙，未侵入胎儿组织。它们呈大的球形，无血管。用Ki-67染色显示有外层增殖壳和内层坏死核心。孕28周时，通过择期剖宫产娩出一名健康新生儿。几周后，经手术及FEC60（氟尿嘧啶、表柔比星、环磷酰胺）化疗周期后，患者死亡。胎盘内的乳腺癌转移很少被描述。孕期特殊的免疫环境可能影响肿瘤及转移灶的表型、生长和行为。
