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创伤性乙状结肠破裂继发于乳腺癌转移:一例报告。

Traumatic sigmoid colon rupture due to breast cancer metastasis: a case report.

机构信息

Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan.

Department of Pathology Diagnosis, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan.

出版信息

Clin J Gastroenterol. 2023 Dec;16(6):854-858. doi: 10.1007/s12328-023-01859-x. Epub 2023 Sep 21.

Abstract

The metastasis of breast cancer to the gastrointestinal tract is rare. Herein, we presented the case of an 85-year-old woman who had a history of invasive lobular carcinoma and experienced complete colon rupture due to relatively low-energy trauma. The patient underwent bilateral total mastectomy and axillary dissection following preoperative chemotherapy 6 years ago. She had a local recurrence 2 years after the surgery and underwent chemotherapy. Subsequently, the cancer metastasized to the thoracolumbar area and retroperitoneum. In addition, the patient fell from a height of 30 cm while hanging laundry and her abdomen hit a hose reel. Emergency surgery was performed, and the entire circumference of the sigmoid colon was ruptured. The ruptured colon lesion was resected, and the stump was closed. A double-barrel transverse colostomy was created as it was impossible to lift the stump up to the abdominal wall. Histopathological examination revealed the invasive lobular carcinoma metastasis and a linitis plastica-like change of the colon wall, which probably consequently weakened. In addition, minimal trauma can damage the gastrointestinal tract that had invasive lobular carcinoma metastasis.

摘要

乳腺癌转移至胃肠道较为罕见。本文报道了 1 例 85 岁女性患者,该患者有浸润性小叶癌病史,曾因相对低能创伤而完全性结肠破裂。患者 6 年前术前化疗后行双侧全乳切除术及腋窝清扫术,术后 2 年局部复发并接受化疗,随后癌症转移至胸腰椎和腹膜后。此外,该患者在晾衣服时从 30cm 高处坠落,腹部撞到了一个软管卷筒。行紧急手术,乙状结肠全周破裂,切除破裂结肠病灶,缝合残端。由于无法将残端提升到腹壁,因此行双套管横结肠造口术。组织病理学检查显示浸润性小叶癌转移和结肠壁的革袋状改变,可能因此而变脆弱。此外,轻微的创伤就可能损伤有浸润性小叶癌转移的胃肠道。

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