Okamoto Takeshi, Suzuki Hidekazu, Fukuda Katsuyuki
Department of Gastroenterology, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan.
Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1143, Japan.
BMC Gastroenterol. 2021 May 25;21(1):240. doi: 10.1186/s12876-021-01823-4.
While double primary cancers are common in breast cancer patients, co-existence of primary gastric cancer and gastric metastases of breast cancer is exceedingly rare.
A 51-year-old woman receiving chemotherapy for breast cancer presented with melena and presyncope. A circumferential thickening of the pylorus and small submucosal tumor-like lesions in the gastric fundus and corpus were confirmed on endoscopy. Immunohistochemistry of biopsies revealed that the former was composed of poorly differentiated gastric cancer cells, while the latter were breast cancer metastases. Distal gastrectomy was performed. Pathological evaluation of the resected specimen revealed gastric adenocarcinoma in the pyloric lesion and breast countless cancer metastases throughout the remainder of the stomach, with positive margins. One lymph node had evidence of both stomach cancer and breast cancer metastases, forming a collision tumor. Despite a successful surgery, the patient died 6 months later due to progression of breast cancer.
We report a case of synchronous primary gastric adenocarcinoma and gastric metastases of breast cancer. Inter-disciplinary collaboration is crucial in determining the optimal treatment in double cancers.
双原发性癌症在乳腺癌患者中很常见，但原发性胃癌与乳腺癌胃转移瘤同时存在的情况极为罕见。
一名51岁接受乳腺癌化疗的女性出现黑便和晕厥前症状。内镜检查证实幽门环形增厚，胃底和胃体有小的黏膜下肿瘤样病变。活检的免疫组织化学显示，前者由低分化胃癌细胞组成，而后者为乳腺癌转移瘤。行远端胃切除术。切除标本的病理评估显示，幽门病变为胃腺癌，胃的其余部分有无数乳腺癌转移灶，切缘阳性。一个淋巴结有胃癌和乳腺癌转移的证据，形成了碰撞瘤。尽管手术成功，但患者6个月后因乳腺癌进展死亡。
我们报告了一例同步原发性胃腺癌和乳腺癌胃转移瘤的病例。多学科协作对于确定双癌的最佳治疗方案至关重要。
