Jackson B, Scott-Conner C, Moulder J
Department of Surgery, University of Mississippi School of Medicine, Jackson 39216-4505, USA.
Am Surg. 1995 May;61(5):431-4.
Axillary metastasis from carcinoma of an unknown primary site is an uncommon and difficult problem. When biopsy of an enlarged axillary node reveals adenocarcinoma, the most likely site (in a female patient) is the ipsilateral breast. From January 1977 to December 1986, 10 patients (eight female, two male) were treated at the University of Mississippi Medical Center for axillary metastasis from carcinoma of unknown primary. Two male patients (ages 60 and 63) were believed to have lung primaries. Both had evidence of distant metastasis at initial diagnosis and died 2 and 7 months after presentation. Of the eight women (ages 40-72, mean 56.5 years), seven developed breast abnormalities between 6 and 39 months (mean: 15 months) after initial diagnosis, and two of these underwent modified radical mastectomy. No primary site was identified in the eight women. Two women had evidence of distant metastases at initial presentation. All patients have died with disease at a mean of 42 months (range: 2-93 months). In contrast with other reported series, the outcome of patients with occult breast carcinoma presenting as axillary adenopathy was not favorable.
原发部位不明的癌肿发生腋窝转移是一个不常见且棘手的问题。当对肿大的腋窝淋巴结进行活检显示为腺癌时，（女性患者中）最可能的原发部位是同侧乳腺。1977年1月至1986年12月期间，密西西比大学医学中心收治了10例原发部位不明的癌肿发生腋窝转移的患者（8例女性，2例男性）。2例男性患者（年龄分别为60岁和63岁）被认为原发于肺部。二者在初诊时均有远处转移的证据，分别在就诊后2个月和7个月死亡。8例女性患者（年龄40 - 72岁，平均56.5岁）中，7例在初诊后6至39个月（平均15个月）出现乳腺异常，其中2例行改良根治性乳房切除术。8例女性患者均未明确原发部位。2例女性患者在初诊时即有远处转移的证据。所有患者均因疾病死亡，平均生存时间为42个月（范围：2 - 93个月）。与其他报道的系列病例相比，以腋窝腺病为表现的隐匿性乳腺癌患者的预后并不理想。
