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小叶型乳腺癌患者回盲瓣转移致盲肠扭转:肠梗阻的罕见原因

Ileocecal Valve Metastasis Inducing Cecal Volvulus in a Patient With Lobular Breast Cancer: A Rare Cause of Bowel Obstruction.

作者信息

Ávila Leonor, Branco Tiago, Leandro Helena, Silva Rita, Mendes Rui, Coelho Fátima

机构信息

General Surgery, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, PRT.

General Surgery, Hospital de Caldas da Rainha, Caldas da Rainha, PRT.

出版信息

Cureus. 2024 Nov 9;16(11):e73345. doi: 10.7759/cureus.73345. eCollection 2024 Nov.

DOI:10.7759/cureus.73345
PMID:39655098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11627466/
Abstract

Invasive lobular carcinoma (ILC) is the second most prevalent form of invasive breast cancer. Characterized by its insidious growth and distinctive histopathological features, ILC often presents with a less predictable metastatic pattern, including potential invasion of the gastrointestinal tract. This report presents the case of a patient with ILC who developed ileocecal valve metastasis leading to cecal volvulus, a rare but critical complication. The slow dissemination of ILC delayed the diagnosis and allowed for significant tumor burden at the ileocecal junction with consequent intestinal occlusion, resulting in acute abdominal symptoms and the need for surgical intervention. Treatment strategies for ILC, which may include surgery, radiation, and systemic therapies, vary based on the tumor's stage and hormonal receptor status. In this particular case, the patient underwent an emergent right hemicolectomy with subsequent treatment with fulvestrant. This case highlights the importance of vigilant monitoring for unusual metastatic sites in ILC and underscores the need for comprehensive treatment approaches tailored to individual patient profiles.

摘要

浸润性小叶癌(ILC)是浸润性乳腺癌的第二常见类型。ILC具有隐匿性生长和独特的组织病理学特征,其转移模式往往较难预测,包括可能侵犯胃肠道。本报告介绍了一例ILC患者,该患者发生回盲瓣转移导致盲肠扭转,这是一种罕见但严重的并发症。ILC的缓慢扩散延迟了诊断,导致回盲部出现大量肿瘤负荷,进而引起肠道梗阻,导致急性腹部症状并需要手术干预。ILC的治疗策略可能包括手术、放疗和全身治疗,具体取决于肿瘤分期和激素受体状态。在这个特殊病例中,患者接受了急诊右半结肠切除术,随后接受氟维司群治疗。该病例强调了对ILC不寻常转移部位进行密切监测的重要性,并强调了根据个体患者情况制定综合治疗方案的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/7e8533458ac8/cureus-0016-00000073345-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/6c1778dede1a/cureus-0016-00000073345-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/c99eec54a589/cureus-0016-00000073345-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/7e8533458ac8/cureus-0016-00000073345-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/6c1778dede1a/cureus-0016-00000073345-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/c99eec54a589/cureus-0016-00000073345-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/11627466/7e8533458ac8/cureus-0016-00000073345-i03.jpg

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本文引用的文献

1
An unwelcome guest: two cases of colonic metastatic lobular breast cancer.一位不受欢迎的访客:两例结肠转移性小叶乳腺癌
J Surg Case Rep. 2023 Mar 28;2023(3):rjad160. doi: 10.1093/jscr/rjad160. eCollection 2023 Mar.
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A rare case of lobular breast cancer metastasizing to large bowel.一例罕见的小叶型乳腺癌转移至大肠的病例。
Clin Case Rep. 2021 May 4;9(5):e04081. doi: 10.1002/ccr3.4081. eCollection 2021 May.
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Distinct Pattern of Metastases in Patients with Invasive Lobular Carcinoma of the Breast.乳腺浸润性小叶癌患者转移的独特模式。
Geburtshilfe Frauenheilkd. 2017 Jun;77(6):660-666. doi: 10.1055/s-0043-109374. Epub 2017 Jun 28.
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Feasibility of the "Bring Your Own Device" Model in Clinical Research: Results from a Randomized Controlled Pilot Study of a Mobile Patient Engagement Tool.“自带设备”模式在临床研究中的可行性:一项移动患者参与工具的随机对照试点研究结果
Cureus. 2016 Mar 16;8(3):e535. doi: 10.7759/cureus.535.