Department of Surgery, Yaizu City Hospital.
Department of Pathology, Yaizu City Hospital 1000 Dobara, Yaizu city, Shizuoka, Japan.
Medicine (Baltimore). 2021 May 28;100(21):e26146. doi: 10.1097/MD.0000000000026146.
Hormone therapies, particularly those targeting estrogen and its receptors, are a key treatment modality for patients with estrogen receptor (ER)-positive breast or ovarian cancer. Some gastric cancers (GCs) express ERs, and preclinical studies suggest the potential of estrogen-targeting hormone therapy on GC; however, the clinical relevance of this hormone therapy on GC treatment has not been well elucidated.
An 80-year-old female was admitted to our department with hypogastric pain and vomiting. Computed tomography demonstrated small bowel obstruction, and laparotomy after bowel decompression revealed peritoneal dissemination consisting of a poorly-differentiated adenocarcinoma. Intestinal bypass between the ileum and transverse colon was performed.
The tumor was ER- and mammaglobin-positive, indicating that it originated from a breast cancer. Diagnostic imaging revealed no evidence of breast cancer; however, right axillary ER- and mammaglobin-positive lymphadenopathy was found.
The patient received hormone therapy using letrozole based on a clinical diagnosis of occult breast cancer with peritoneal dissemination and right axillary lymph node metastasis.
The patient remained disease free until 37 months but deceased at 53 months from the onset of disease. An autopsy revealed no tumor cells in the right breast tissue; however, there was a massive invasion of cancer cells in the stomach.
A patient with ER positive GC with peritoneal dissemination and right axillary lymph node metastasis presented remarkable response to letrozole. The long-term survival obtained using letrozole for a patient with GC with distant metastasis suggests the potential of estrogen targeting hormone therapies for GC.
激素疗法，特别是针对雌激素及其受体的疗法，是雌激素受体（ER）阳性乳腺癌或卵巢癌患者的主要治疗方式。一些胃癌（GC）表达 ER，临床前研究表明雌激素靶向激素治疗对 GC 具有潜在作用；然而，这种激素治疗对 GC 治疗的临床相关性尚未得到充分阐明。
一名 80 岁女性因下腹疼痛和呕吐入住我科。计算机断层扫描显示小肠梗阻，肠减压后的剖腹探查显示腹膜扩散，包括低分化腺癌。在回肠和横结肠之间进行肠旁路。
肿瘤 ER 和乳球蛋白阳性，表明它起源于乳腺癌。诊断性影像学检查未发现乳腺癌证据；然而，发现右侧腋窝 ER 和乳球蛋白阳性淋巴结病。
根据隐匿性乳腺癌伴腹膜扩散和右侧腋窝淋巴结转移的临床诊断，患者接受了来曲唑激素治疗。
患者无病生存至 37 个月，但在发病后 53 个月死亡。尸检显示右侧乳腺组织中无肿瘤细胞，但胃内有大量癌细胞浸润。
一名 ER 阳性 GC 伴腹膜扩散和右侧腋窝淋巴结转移的患者对来曲唑表现出显著的反应。对于患有远处转移的 GC 患者，来曲唑可获得长期生存，这表明针对雌激素的激素治疗对 GC 具有潜在作用。
