Yamada Kenta, Kaneko Junichi, Watahiki Moeka, Ida Yuya, Koda Megumu, Fukita Kyoichi, Takeshita Yu, Takahashi Kenichi, Takinami Masaki, Tsuji Atsushi, Nishino Masafumi, Takahashi Yurimi, Sasada Yuzo, Yamada Takanori
Division of Gastroenterology Iwata City Hospital Shizuoka Japan.
Division of Hepatology Iwata City Hospital Shizuoka Japan.
DEN Open. 2022 Apr 5;2(1):e115. doi: 10.1002/deo2.115. eCollection 2022 Apr.
For gastric lesions in a patient with a history of breast cancer, it is essential to distinguish between primary gastric cancer and gastric metastasis from breast cancer. However, gastric metastasis from breast cancer often mimics primary linitis plastica, and histological diagnosis may be difficult with conventional endoscopic biopsies. Herein, we describe the case of a 75-year-old woman who presented at our hospital with epigastralgia and vomiting. She had a history of mastectomy for carcinoma of the right breast and had received hormone therapy as adjuvant therapy. Computed tomography at arrival showed thickening of the gastric wall at the antrum and peritoneal dissemination. Esophagogastroduodenoscopy showed mucosal swelling of the antrum and stenosis of the pylorus, and histological diagnosis failed with conventional endoscopic biopsies. Endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle was performed, and a diagnosis of gastric metastasis from breast cancer was made. She received hormone therapy and chemotherapy after deployment of a metallic stent for gastric outlet obstruction. To the best of our knowledge, this is the first case of gastric metastasis from breast cancer diagnosed using endoscopic ultrasound-guided fine-needle biopsy.
对于有乳腺癌病史的患者出现胃部病变,区分原发性胃癌和乳腺癌的胃转移至关重要。然而,乳腺癌的胃转移常类似原发性皮革胃,传统内镜活检可能难以进行组织学诊断。在此,我们描述了一名75岁女性的病例,她因上腹痛和呕吐前来我院就诊。她有右乳癌乳房切除术病史,并接受过激素治疗作为辅助治疗。入院时的计算机断层扫描显示胃窦部胃壁增厚及腹膜播散。食管胃十二指肠镜检查显示胃窦部黏膜肿胀及幽门狭窄,传统内镜活检未能做出组织学诊断。使用 Franseen 针进行了内镜超声引导下细针穿刺活检,诊断为乳腺癌胃转移。在置入金属支架治疗胃出口梗阻后,她接受了激素治疗和化疗。据我们所知,这是首例使用内镜超声引导下细针穿刺活检诊断的乳腺癌胃转移病例。