Sato Ayana, Matsumoto Akiko, Naruse Saki, Isono Yuka, Maeda Yuka, Yamada Miki, Ikeda Tatsuhiko, Sasajima Yuko, Jinno Hiromitsu
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.
Department of Pathology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan.
Surg Case Rep. 2023 Feb 1;9(1):13. doi: 10.1186/s40792-023-01598-8.
Tumor embolization due to venous infiltration of breast cancer pulmonary metastases is very rare.
A 72-year-old female was diagnosed with triple-negative breast cancer. Neoadjuvant chemotherapy was discontinued because of progressive disease, and a right mastectomy with sentinel lymph node biopsy was performed. The pathological analysis of surgical specimens revealed carcinoma with cartilaginous and/or osseous metaplasia. At 22 months after surgery, lung metastasis was observed, and 6 months after initiating treatment for lung metastases, she complained of sudden numbness in the left-lower limb with trouble walking. Ultrasonography showed an embolism in the left popliteal artery, and contrast computed tomography showed enlarged lung metastases and infiltration of the left-upper lobe disease into the left superior pulmonary vein and left atrium. Acute arterial occlusive disease in the left-lower limb caused by the tumor embolism was suspected, so an endovascular thrombectomy was performed. Tumor emboli were removed by embolectomy catheter.
This report of lung metastasis from breast cancer with cartilaginous and/or osseous metaplasia and acute lower-limb artery occlusion due to a tumor thrombus adds useful information to the literature on these extremely rare cases.
乳腺癌肺转移静脉浸润导致的肿瘤栓塞非常罕见。
一名72岁女性被诊断为三阴性乳腺癌。由于疾病进展，新辅助化疗中断，行右侧乳房切除术并进行前哨淋巴结活检。手术标本的病理分析显示为伴有软骨和/或骨化生的癌。术后22个月观察到肺转移，在开始治疗肺转移6个月后，她主诉左下肢突然麻木并行走困难。超声检查显示左腘动脉栓塞，对比计算机断层扫描显示肺转移灶增大，左上叶病灶浸润至左上肺静脉和左心房。怀疑肿瘤栓塞导致左下肢急性动脉闭塞性疾病，因此进行了血管内血栓切除术。通过取栓导管取出肿瘤栓子。
本报告关于伴有软骨和/或骨化生的乳腺癌肺转移以及肿瘤血栓导致急性下肢动脉闭塞的病例，为这些极其罕见病例的文献增添了有用信息。
