Nagao Atsuki, Noie Tamaki, Horiuch Hajime, Yamada Haruyasu, Momiyama Masashi, Nakajima Kentaro, Satou Shouichi, Satodate Hitoshi, Nara Satoshi, Harihara Yasushi
Department of Surgery, NTT Medical Center Tokyo, 5-9-22, Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
Department of Pathology, NTT Medical Center Tokyo, Tokyo, Japan.
Surg Case Rep. 2021 Feb 3;7(1):39. doi: 10.1186/s40792-021-01124-8.
Patients with advanced-stage breast cancer often demonstrate pancreatic metastases. However, pancreatic metastases resection from breast cancer has been rarely performed, with only 20 cases having been reported to date.
A 49-year-old woman presented to our hospital in September 2003 with complaints of uncontrollable oozing from her left breast tumor. Computed tomography revealed a left breast tumor approximately 9.3 cm in diameter as well as heterogeneously enhanced solid mass lesions with necrotic foci in the pancreatic tail and body, up to 6.2 cm, which were radiologically diagnosed as pancreatic metastases from breast cancer. An emergent left simple mastectomy was performed to control bleeding. After epirubicin and cyclophosphamide hydrate treatment failed to improve her condition, the pancreatic metastases responded to weekly paclitaxel treatment, but eventually regrew. The patient underwent distal pancreatectomy with splenectomy, left adrenalectomy, partial stomach resection, and paraaortic lymph nodes excision in December 2004 after no other metastasis was confirmed. Furthermore, she received radiation therapy for left parasternal lymph node metastasis 6 months later. The patient recovered well. Consequently, she has no evidence of disease > 15 years after pancreatectomy.
This is the first reported case of pancreatectomy for pancreatic metastases from breast cancer, which was simultaneously diagnosed. Patients with no metastasis other than resectable pancreatic metastases and breast cancer and who possess some sensitivity for chemotherapy may benefit from pancreatectomy.
晚期乳腺癌患者常出现胰腺转移。然而,乳腺癌胰腺转移灶切除术很少进行,迄今为止仅报道过20例。
一名49岁女性于2003年9月因左乳肿瘤无法控制地渗液而就诊于我院。计算机断层扫描显示左乳有一个直径约9.3厘米的肿瘤,以及胰尾和胰体部有不均匀强化的实性肿块病变,伴有坏死灶,最大直径达6.2厘米,经放射学诊断为乳腺癌胰腺转移。急诊行左乳单纯切除术以控制出血。在表柔比星和环磷酰胺水合物治疗未能改善病情后,胰腺转移灶对每周一次的紫杉醇治疗有反应,但最终复发。2004年12月,在未确认有其他转移灶后,患者接受了胰体尾切除术、脾切除术、左肾上腺切除术、部分胃切除术和腹主动脉旁淋巴结切除术。此外,6个月后她因左胸骨旁淋巴结转移接受了放射治疗。患者恢复良好。因此,在胰体尾切除术后15年多,她没有疾病复发的迹象。
这是首例同时诊断出乳腺癌胰腺转移灶并进行胰体尾切除术的报道病例。除可切除的胰腺转移灶和乳腺癌外无其他转移灶且对化疗有一定敏感性的患者可能从胰体尾切除术中获益。