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不同乳腺外恶性肿瘤转移至乳房的罕见病例:系列病例的多模态影像学方法。

Unusual metastases to the breast from different extramammary malignancies: a multimodality imaging approach in a case series.

机构信息

Department of Radiology, National Cancer Institute, Mexico City, Mexico.

Department of Pathology, National Cancer Institute, Mexico City, Mexico.

出版信息

Chin Clin Oncol. 2024 Aug;13(4):53. doi: 10.21037/cco-23-142. Epub 2024 Jun 25.

Abstract

Extramammary metastases are uncommon and usually related to a poor prognosis, but the radiologist can suspect the diagnosis based on the patient's clinical history and specific imaging findings. Several imaging procedures may be used to evaluate breast metastases from different extramammary malignancies, including mammography, ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography-CT (PET-CT). The clinical and imaging presentation of these metastases is contingent upon how the illness spreads, however, they have the potential to resemble either benign or malignant breast tumors. Metastases that disseminate hematologically tend to appear as a single round or oval mass with circumscribed margins. Sonographically, they are usually hypoechoic, and with CT or MRI, they usually enhance. Lymphatic dissemination, for example, frequently reveals significant asymmetry with skin thickening and diffuse breast edema, which is compatible with an inflammatory breast carcinoma. Knowing the many types of cancers that have the potential to spread to the breast as well as being able to accurately diagnose them is crucial to prevent a needless mastectomy and provide guidance for subsequent treatment. The purpose of this article is to provide a better understanding of the imaging features and immunohistochemistry (IHC) of secondary tumors of the breast by presenting eight distinctive cases, which will enable radiologists to recognize this entity.

摘要

非乳腺转移较为罕见,通常与预后不良有关,但放射科医生可以根据患者的临床病史和特定的影像学表现怀疑诊断。有几种影像学检查可用于评估来自不同非乳腺恶性肿瘤的乳腺转移,包括乳房 X 线摄影、超声、磁共振成像(MRI)、计算机断层扫描(CT)和正电子发射断层扫描-CT(PET-CT)。这些转移的临床和影像学表现取决于疾病的传播方式,但它们有可能类似于良性或恶性乳腺肿瘤。通过血液传播的转移倾向于表现为边界清楚的单个圆形或椭圆形肿块。超声检查通常为低回声,CT 或 MRI 检查时通常增强。例如,淋巴传播通常会显示出明显的不对称性,皮肤增厚和弥漫性乳腺水肿,这与炎性乳腺癌相符。了解有潜在可能转移到乳房的多种癌症类型,并能够准确诊断它们,对于防止不必要的乳房切除术和为后续治疗提供指导至关重要。本文的目的是通过介绍 8 个不同的病例,提供对乳腺继发性肿瘤的影像学特征和免疫组织化学(IHC)的更好理解,使放射科医生能够识别该实体。

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