Bai Xue, Fang Canbin, Liu Binliang, Huagn Jiayi, Chen Xuelian, Xie Xiaofeng, Zhang Qiuyi, Liu Meidi, Liang Jinyan, Guo Jinfeng, Song Lin, Lan Xiaofeng, Chen Liping, Huang Suni, Deng Wencui, Luo Zhenzhen, Du Caiwen
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China.
Cancer Center and Department of Breast and Thyroid Surgery, Xiang'an Hospital of Xiamen University, Xiamen, Fujian 361100, P.R. China.
Oncol Lett. 2023 Jul 20;26(3):386. doi: 10.3892/ol.2023.13972. eCollection 2023 Sep.
The most common sites of metastasis for breast cancer are the soft tissues, bones, lungs, liver and brain; however, metastases to the gastrointestinal tract and thyroid gland from breast cancer rarely occur. The present study describes the case of a 30-year-old woman who developed gastric and thyroid metastases 5 years after her initial diagnosis of invasive ductal breast carcinoma. The initial pathological diagnosis when receiving modified radical mastectomy was invasive ductal carcinoma, and further immunohistochemical examination revealed the cancer to be estrogen receptor (-), progesterone receptor (-), human epidermal growth factor receptor 2 (HER2; ++) and Ki-67 (70%). Genetic testing indicated the HER2 amplification mutation, whereas BRCA1/2 testing was negative. A total of 21 months after surgery, during regular follow-up, the patient was revealed to have developed an enlarged lymph node in the left side of the neck and the first recurrence was confirmed. Approximately 5 years after surgery, the patient gradually developed multi-site metastasis, and developed metastases to the thyroid gland and stomach confirmed by pathology and imaging. Combined chemotherapy and targeted therapy were administered and exhibited good efficacy; however, the patient subsequently died due to heart failure. This case report describes the occurrence of gastric and thyroid metastases from breast cancer, and highlights the importance of distinguishing between metastatic and primary tumors. Distinguishing between a metastatic and primary tumor is crucial as treatment protocols vary significantly for these two types of tumors. For patients with a history of breast cancer it should first be considered whether they have metastasis of the primary disease or discomfort caused by treatment; however, the possibility of a second primary tumor cannot be ignored. If the patient has symptoms such as loss of appetite, nausea, vomiting, stomach pain and stomach discomfort, a gastroscopy should be performed in a timely manner.
乳腺癌最常见的转移部位是软组织、骨骼、肺、肝脏和脑；然而，乳腺癌转移至胃肠道和甲状腺的情况很少见。本研究描述了一名30岁女性的病例，她在初次诊断为浸润性导管乳腺癌5年后出现了胃和甲状腺转移。接受改良根治性乳房切除术后的初始病理诊断为浸润性导管癌，进一步的免疫组化检查显示该癌症为雌激素受体（-）、孕激素受体（-）、人表皮生长因子受体2（HER2；++）和Ki-67（70%）。基因检测显示HER2扩增突变，而BRCA1/2检测为阴性。术后共21个月，在定期随访期间，发现患者左侧颈部淋巴结肿大，确诊为首次复发。术后约5年，患者逐渐出现多部位转移，并经病理和影像学检查确诊转移至甲状腺和胃。给予联合化疗和靶向治疗，疗效良好；然而，患者随后因心力衰竭死亡。本病例报告描述了乳腺癌发生胃和甲状腺转移的情况，并强调了区分转移瘤和原发肿瘤的重要性。区分转移瘤和原发肿瘤至关重要，因为这两种类型肿瘤的治疗方案差异很大。对于有乳腺癌病史的患者，首先应考虑是否存在原发疾病转移或治疗引起的不适；然而，也不能忽视发生第二原发肿瘤的可能性。如果患者出现食欲不振、恶心、呕吐、胃痛和胃部不适等症状，应及时进行胃镜检查。
