Kim Kyeong Eui, Lee Hye Won, Bae Sung Uk
Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Korean J Clin Oncol. 2024 May;20(1):41-45. doi: 10.14216/kjco.24007. Epub 2024 Jun 30.
Breast cancer is the most common cancer among women worldwide. Breast cancer often metastasizes to the regional lymph nodes, bone, brain, liver, and lungs, whereas gastrointestinal tract metastases are rare. Herein, we present a rare case of rectal metastasis from breast cancer that occurred during palliative chemotherapy. A 69-year-old female with a history of invasive ductal carcinoma, negative for hormonal receptors and positive for human epidermal growth factor receptor 2 (HER2) receptor, underwent various treatments, including neoadjuvant chemotherapy, breast-conserving surgery, and adjuvant therapy. Eight months postoperatively, the patient experienced axillary lymph node recurrence, requiring palliative chemotherapy. Despite ongoing treatment, metastatic lesions were confirmed in the lungs and pleura. During palliative chemotherapy, the patient developed anal pain, and subsequent examination revealed an infiltrating rectal lesion. Despite histological confirmation of metastatic breast carcinoma and tubular adenoma, a multidisciplinary decision was made regarding palliative chemotherapy over surgical intervention. Eribulin was administered, but due to the patient's inability to tolerate the treatment, she passed away 3 months after rectal lesion diagnosis. Although breast cancer metastasis to the rectum is rare, clinicians should consider the possibility of rectal involvement and perform a digital rectal examination if anal symptoms are present.
乳腺癌是全球女性中最常见的癌症。乳腺癌常转移至区域淋巴结、骨骼、大脑、肝脏和肺部,而胃肠道转移则较为罕见。在此,我们报告一例在姑息化疗期间发生的乳腺癌直肠转移罕见病例。一名69岁女性,有浸润性导管癌病史,激素受体阴性,人表皮生长因子受体2(HER2)受体阳性,接受了包括新辅助化疗、保乳手术和辅助治疗在内的多种治疗。术后八个月,患者出现腋窝淋巴结复发,需要进行姑息化疗。尽管持续治疗,但仍在肺部和胸膜发现了转移病灶。在姑息化疗期间,患者出现肛门疼痛,随后检查发现直肠有浸润性病变。尽管组织学证实为转移性乳腺癌和管状腺瘤,但还是做出了多学科决定,选择姑息化疗而非手术干预。给予了艾瑞布林治疗,但由于患者无法耐受该治疗,在直肠病变诊断后3个月去世。尽管乳腺癌转移至直肠罕见,但如果出现肛门症状,临床医生应考虑直肠受累的可能性并进行直肠指检。