Ho Ren Yi Jonas, Rajesh R, Wan Wei Keat, Cheah Chang Chuen Mark, Tan Yi Yuan
Department of Gastroenterology and Hepatology Singapore General Hospital Singapore.
Department of Anatomical Pathology Singapore General Hospital Singapore.
JGH Open. 2024 Dec 20;8(12):e70071. doi: 10.1002/jgh3.70071. eCollection 2024 Dec.
Linitis plastica is a challenging diagnosis in the setting of a patient with previous breast cancer.
We present a case of a 74-year-old Chinese Female with a history of breast cancer who presented with epigastric pain, nausea, early satiety, and weight loss of 5 kg in 3 months. Endoscopic diagnosis of linitis plastica was made, but subsequent management plans were dependent on accurate histological assessment in view of her oncological history.
Our case highlights the clinical conundrum confronting the endoscopist in evaluating suspected linitis plastica where the imaging, endoscopic, and macroscopic histological findings between primary gastric adenocarcinoma and metastatic breast cancer can be indistinguishable. Optimal deep tissue acquisition is required to differentiate the true diagnosis in such cases.
在既往有乳腺癌病史的患者中,皮革胃是一种具有挑战性的诊断。
我们报告一例74岁中国女性,有乳腺癌病史,出现上腹部疼痛、恶心、早饱,3个月内体重减轻5千克。内镜诊断为皮革胃,但鉴于其肿瘤病史,后续治疗方案取决于准确的组织学评估。
我们的病例突出了内镜医师在评估疑似皮革胃时面临的临床难题,原发性胃腺癌和转移性乳腺癌之间的影像学、内镜及大体组织学表现可能难以区分。在此类病例中,需要进行最佳的深部组织取材以鉴别真正的诊断。