Aoki Kana, Kametaka Hisashi, Makino Hironobu, Fukada Tadaomi, Akiyama Takahiro, Hyakutake Yoshiaki, Yoshida Hayato, Mitomi Hiroyuki, Seike Kazuhiro
Dept. of Surgery, Odawara Municipal Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2352-2354.
We herein report the case of a 76-year-old female patient who had undergone gastrectomy for advanced gastric cancer (histologically tubular adenocarcinoma)before 5 months, presenting with abdominal skin tumor. A skin biopsy revealed tubular adenocarcinoma. Positron emission tomography-computed tomographic scanning detected right breast tumor. A partial mastectomy of the right breast and local resection of abdominal skin tumor were performed and both tumors depicted similar histology of tubular adenocarcinoma in routine pathological examination. Immunohistochemically, positive for CDX2 and MUC5AC in previously resected gastric cancer and skin tumor tissues, whereas negative for both antigens in breast cancer. Thus, the final pathological diagnosis demonstrated skin metastasis originating from gastric cancer and primary breast cancer(invasive ductal carcinoma)histologically mimicking gastric cancer. We emphasize difficulties in diagnosis of this situation and that immunohistochemistry is helpful to distinguish primary breast cancer from gastric cancer metastasizing to the breast.
我们在此报告一例76岁女性患者，该患者在5个月前因晚期胃癌（组织学类型为管状腺癌）接受了胃切除术，现出现腹部皮肤肿瘤。皮肤活检显示为管状腺癌。正电子发射断层扫描-计算机断层扫描检测到右乳腺肿瘤。对右乳腺进行了部分乳房切除术，并对腹部皮肤肿瘤进行了局部切除，在常规病理检查中，这两个肿瘤均显示出类似的管状腺癌组织学特征。免疫组织化学检查显示，先前切除的胃癌和皮肤肿瘤组织中CDX2和MUC5AC呈阳性，而乳腺癌组织中这两种抗原均为阴性。因此，最终病理诊断显示为皮肤转移癌，原发于胃癌，而原发性乳腺癌（浸润性导管癌）在组织学上与胃癌相似。我们强调了这种情况诊断的困难，并且免疫组织化学有助于区分原发性乳腺癌和转移至乳腺的胃癌。
