Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris, France.
Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris, France.
J Gynecol Obstet Hum Reprod. 2021 Jan;50(1):101993. doi: 10.1016/j.jogoh.2020.101993. Epub 2020 Nov 17.
Breast cancer is the leading cause of cancer death in women, and most breast cancer related deaths are due to metastases. Uterine metastases from breast cancer are uncommon and rarely reported in the literature. We described the case of a 50 years-old-woman who developed a uterine metastasis, 6 years after the diagnosis of an invasive ductal breast carcinoma. Indeed, although the patient was asymptomatic, the monitoring imaging examinations, particularly the computed tomography (CT) and the positron emission tomography/computed tomography (PET/CT), showed a myometrial lesion. Non-conservative total hysterectomy was performed. The anatomo-pathological examination revealed a myometrial metastasis from an invasive ductal breast carcinoma. Seventeen months after surgery, the patient had no pelvic recurrence, but lungs and bones metastases progressed despite chemotherapy. In the lack of guidelines of uterine metastases from breast cancer's management, we reviewed the existing literature with the aim to provide a rational framework for clinical presentation, diagnostic approach, histological findings and treatment of this rare and heterogeneous pathology. Uterine metastases of breast cancer are frequently revealed with metrorrhagia. They occur preferentially in tumours with initial lobular carcinoma, initial lymph node involvement and positive hormonal receptors.
乳腺癌是女性癌症死亡的主要原因，大多数与乳腺癌相关的死亡是由于转移。乳腺癌的子宫转移并不常见，在文献中也很少报道。我们描述了一例 50 岁女性的病例，她在诊断为浸润性导管乳腺癌 6 年后出现了子宫转移。事实上，尽管患者无症状，但监测影像学检查，特别是计算机断层扫描（CT）和正电子发射断层扫描/计算机断层扫描（PET/CT），显示出子宫肌层病变。进行了非保守性全子宫切除术。解剖病理学检查显示为浸润性导管乳腺癌的子宫肌层转移。手术后 17 个月，患者无盆腔复发，但尽管进行了化疗，肺部和骨骼转移仍在进展。由于缺乏乳腺癌子宫转移管理的指南，我们回顾了现有文献，旨在为这种罕见且异质性的病理学的临床表现、诊断方法、组织学发现和治疗提供合理的框架。乳腺癌的子宫转移常伴有月经过多。它们最初发生在具有小叶癌、初始淋巴结受累和阳性激素受体的肿瘤中。
