Schellenberg Angela E, Wood Melissa Lillian, Baniak Nick, Hayes Paul
Department of General Surgery, Selkirk Regional Health Centre, Selkirk, Manitoba, Canada.
Department of Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.
BMJ Case Rep. 2018 May 26;2018:bcr-2018-224216. doi: 10.1136/bcr-2018-224216.
Breast cancer is the most common malignancy among women, while invasive ductal carcinoma is the most common type of invasive breast cancer. Metastatic spread to the colon and rectum in breast cancer is rare. This report describes a case of a 69-year-old woman with metastatic ductal breast cancer to the rectosigmoid, presenting as an incidental finding on screening colonoscopy. The breast carcinoma was first diagnosed 2 years prior. Colonic biopsies from colonoscopy confirmed metastatic adenocarcinoma consistent with a breast primary. Ultimately her clinical condition worsened as she developed malignant ascites, a small bowel obstruction, and new bone metastases, and the patient succumbed to her illness. Cases of metastatic breast cancer to the gastrointestinal tract have predominantly been lobular breast carcinoma. Increased awareness of colonic metastasis may lead to more accurate diagnosis and earlier systemic treatment.
乳腺癌是女性中最常见的恶性肿瘤,而浸润性导管癌是浸润性乳腺癌最常见的类型。乳腺癌转移至结肠和直肠较为罕见。本报告描述了一例69岁女性,其直肠乙状结肠发生转移性导管乳腺癌,在结肠镜筛查时偶然发现。乳腺癌最初于2年前确诊。结肠镜检查获取的结肠活检证实为转移性腺癌,与乳腺原发肿瘤相符。最终,她的临床状况恶化,出现恶性腹水、小肠梗阻和新的骨转移,患者因病死亡。胃肠道转移性乳腺癌病例主要为小叶型乳腺癌。提高对结肠转移的认识可能会导致更准确的诊断和更早的全身治疗。