Koufopoulos Nektarios, Goudeli Christina, Pigadioti Eleni, Balalis Dimitrios, Manatakis Dimitrios K, Antoniadou Foteini, Korkolis Dimitris P
Department of Pathology, "Saint Savvas" Cancer Hospital, Athens, GRC.
Department of Gynecology, "Saint Savvas" Cancer Hospital, Athens, GRC.
Cureus. 2018 Aug 27;10(8):e3207. doi: 10.7759/cureus.3207.
Invasive lobular carcinoma is the second-most-common subtype of invasive breast carcinoma. Its metastatic pattern is different compared to invasive carcinoma-no special type. It metastasizes more often to the gastrointestinal tract, peritoneum, pleura, and ovaries. The extrahepatic gastrointestinal tract metastases occur mostly in the stomach and small intestine and less often in the colon and rectum. We present a case description of an 87-year-old woman admitted to our hospital with hematochezia, abdominal discomfort, fatigue, and weight loss. A colonoscopy revealed an exophytic tumor of the sigmoid colon. Metastatic disease was not found in imaging studies. A low anterior resection was performed. The pathologic examination revealed a collision tumor consisting of a poorly differentiated adenocarcinoma of the colon and metastatic lobular carcinoma. The diagnosis was challenging due to the lack of a previous history. Also, the diffuse architectural pattern and signet ring cells found may be in primary signet ring carcinoma of the colon as well as in carcinomas from other anatomical sites. Immunohistochemistry was helpful in making the diagnosis. A review of the literature revealed that this is the fourth case of metastatic breast carcinoma coexisting with colonic adenocarcinoma.
浸润性小叶癌是浸润性乳腺癌的第二常见亚型。与浸润性非特殊型癌相比，其转移模式有所不同。它更常转移至胃肠道、腹膜、胸膜和卵巢。肝外胃肠道转移大多发生在胃和小肠，较少发生在结肠和直肠。我们报告一例87岁女性患者，因便血、腹部不适、乏力和体重减轻入院。结肠镜检查发现乙状结肠有一外生性肿瘤。影像学检查未发现转移病灶。行低位前切除术。病理检查显示为碰撞瘤，由结肠低分化腺癌和转移性小叶癌组成。由于缺乏既往病史，诊断具有挑战性。此外，发现的弥漫性结构模式和印戒细胞可能见于结肠原发性印戒细胞癌以及其他解剖部位的癌。免疫组化有助于诊断。文献回顾显示，这是第四例转移性乳腺癌与结肠腺癌共存的病例。
