Dorantes-Heredia Rita, Motola-Kuba Daniel, Ruiz-Morales Jose Manuel, Muñoz-Castañeda Wallace Rafael A, Vega-Ochoa Carolina, De la Peña Roberto
Anatomic Pathology Research Unit, Médica Sur Hospital and Clinical Foundation, Mexico City, Mexico.
Oncology Research Unit, Médica Sur Hospital and Clinical Foundation, Mexico City, Mexico.
Case Rep Oncol. 2018 Aug 10;11(2):541-548. doi: 10.1159/000491600. eCollection 2018 May-Aug.
We report a case of metastases from a cancer of unknown primary whose primary site could not be identified during the appropriate pretreatment evaluation. The patient was a 58-year-old woman with a history of passive smoking and with no history of cancer in the family. Her current condition started with asthenia, adynamia, and pallor, followed by palpitations. An abdominopelvic computed tomography (CT) scan was performed, showing multiple osteolytic lesions distributed in all bone structures and axillary adenopathy on the left side. As part of the approach and given the high suspicion of multiple myeloma, tests were performed. The results were negative for multiple myeloma. A PET-CT scan was performed and showed left axillary adenopathy. The breasts and other organs were not affected. Left axillary lymph node resection revealed breast primary metastatic pleomorphic lobular carcinoma. Due to the metastatic disease (caused by the primary breast cancer), it was decided to start chemotherapy.
我们报告一例原发灶不明的癌症转移病例，在适当的预处理评估期间无法确定其原发部位。患者为一名58岁女性，有被动吸烟史，家族中无癌症病史。她目前的症状始于乏力、动力不足和面色苍白，随后出现心悸。进行了腹部盆腔计算机断层扫描（CT），显示多个溶骨性病变分布于所有骨骼结构以及左侧腋窝淋巴结肿大。作为诊断方法的一部分，鉴于高度怀疑多发性骨髓瘤，进行了相关检查。结果显示多发性骨髓瘤为阴性。进行了PET-CT扫描，显示左侧腋窝淋巴结肿大。乳房和其他器官未受影响。左侧腋窝淋巴结切除显示为乳腺原发性转移性多形性小叶癌。由于转移性疾病（由原发性乳腺癌引起），决定开始化疗。
