Department of Breast Surgery, Second Affiliated Hospital of Jilin University, Changchun, 130041, China.
BMC Womens Health. 2023 Mar 25;23(1):133. doi: 10.1186/s12905-023-02267-6.
Chinese women topped the list of new breast cancers, the first diagnosed gastric metastasis and bone metastasis is extremely infrequent. The clinical and pathological diagnosis of metastatic breast cancer is difficult. To our knowledge, this is the first reported case of the first diagnosis of breast cancer with both gastric metastasis and bone metastasis.
The female patient was found to have abdominal distension for 15 days with nausea and vomiting. The patient underwent a gastroscopy at an outside hospital 4 days ago, showing: duodenal bulb changes, gastric retention and chronic non-atrophic gastritis. Gastroscopic biopsy showed chronic inflammation and edema of the duodenal mucosa with glandular hyperplasia. Conservative treatment was given with no relief of symptoms. She was seen in our hepatobiliary and pancreatic surgery department. After admission, palliative surgery was performed, and the swelling and surrounding involved tissues were taken for examination during surgery. The rapid pathological return could not exclude tumor lesions, and the postoperative pathology confirmed the diagnosis of invasive lobular carcinoma of the breast with gastric metastases, and the systemic examination revealed combined bone metastases.
Pathology and immunohistochemistry(IHC), a whole-body bone scan confirmed the first diagnosis of breast cancer with both gastric and bone metastases.
Palliative treatment with bisphosphonates and CDK4/6i (Palbociclib) in combination with AI (Exemestane) was administered.
The patient is currently under regular evaluation and is being followed up.
中国女性乳腺癌新发病例数居全球首位,首次诊断胃转移和骨转移的极为罕见。转移性乳腺癌的临床和病理诊断困难。据我们所知,这是首例首次诊断为乳腺癌同时伴有胃转移和骨转移的病例报告。
该女性患者因腹胀 15 天伴恶心呕吐就诊。患者于 4 天前在外院行胃镜检查,显示:十二指肠球部改变,胃潴留,慢性非萎缩性胃炎。胃镜活检显示十二指肠黏膜慢性炎症伴水肿,腺体增生。给予保守治疗,症状无缓解。遂至我院肝胆胰外科就诊。入院后行姑息性手术,术中取肿胀及周围累及组织送检。快速病理回报不能排除肿瘤病变,术后病理证实为乳腺浸润性小叶癌伴胃转移,全身检查发现合并骨转移。
病理及免疫组化(IHC)、全身骨扫描明确了首次诊断为乳腺癌同时伴有胃和骨转移。
给予双膦酸盐和 CDK4/6i(帕博西利)联合 AI(依西美坦)的姑息治疗。
患者目前正在接受定期评估和随访。