Al Qahtani Shaya Yaanallah, Al Argan Reem Jaafar
Department of Internal Medicine, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Saudi J Med Med Sci. 2019 Sep-Dec;7(3):190-194. doi: 10.4103/sjmms.sjmms_49_17. Epub 2019 Aug 28.
Breast cancer is common among females worldwide and is most commonly reported in women aged 30-40 years and less commonly in those aged <30 years. Presentation with liver metastasis is rare in breast cancer at all ages. Lactic acidosis in association with metastatic breast cancer is also rare. Here, the authors report a case of a 26-year-old female who presented with cholestatic jaundice, coagulopathy and ascites. Radiological examination showed evidence of infiltrating liver lesion. Computed tomography-guided liver biopsy confirmed the diagnosis of adenocarcinoma of breast origin based on the strong estrogen receptor positivity. Chemotherapy could not be initiated because of the patient's critical condition. Unfortunately, the condition deteriorated rapidly, and the patient died secondary to liver failure manifested with disseminated intravascular coagulation and lactic acidosis. This is a rare case of breast cancer in terms of age group (<30 years), site of metastasis at presentation and complication of metastatic breast cancer (type B lactic acidosis), and thus highlights the distinct features of such breast cancers.
乳腺癌在全球女性中很常见，最常见于30至40岁的女性，而在30岁以下的女性中较少见。乳腺癌在各个年龄段出现肝转移的情况都很罕见。转移性乳腺癌伴发乳酸性酸中毒也很罕见。在此，作者报告一例26岁女性，该患者表现为胆汁淤积性黄疸、凝血病和腹水。影像学检查显示有肝脏浸润性病变的证据。计算机断层扫描引导下的肝脏活检基于雌激素受体强阳性确诊为乳腺来源的腺癌。由于患者病情危急，无法开始化疗。不幸的是，病情迅速恶化，患者因出现弥散性血管内凝血和乳酸性酸中毒的肝功能衰竭而死亡。就年龄组（<30岁）、就诊时转移部位以及转移性乳腺癌的并发症（B型乳酸性酸中毒）而言，这是一例罕见的乳腺癌病例，因此突出了这类乳腺癌的独特特征。
