Friedrich T, Kellermann S, Leinung S
Chirurgische Klinik I, Universität Leipzig.
Zentralbl Chir. 1997;122(2):117-21.
We report a case of unusual metastases from a gastric cancer. In a 66 years old female with bone metastases a breast cancer was diagnosed. The patient was treated by ablative surgery and chemotherapy but died short time later. An autopsy was performed and showed a large signetring cell carcinoma of the stomach. Further a diffuse involvement of the spleen unknown until autopsy was diagnosed. Serial tissue sections of all metastatic localizations were made. Histopathology and immunostaining including oestroprogesterone receptors identified a gastric cancer as the primary malignancy. A review of the recent literature on breast metastases from gastrointestinal tumours, gastric metastases from breast cancer and the problem of second primary malignancies is given. Further we reviewed the occult metastatic spread of the spleen and the importance of splenectomy in case of total gastrectomy.
我们报告一例罕见的胃癌转移病例。一名66岁患有骨转移的女性被诊断为乳腺癌。该患者接受了根治性手术和化疗，但不久后死亡。进行了尸检，结果显示胃内有一个大的印戒细胞癌。此外，直到尸检才诊断出脾脏存在弥漫性受累。对所有转移部位制作了连续组织切片。组织病理学和免疫染色（包括雌激素和孕激素受体检测）确定胃癌为原发性恶性肿瘤。本文回顾了近期关于胃肠道肿瘤转移至乳腺、乳腺癌转移至胃以及第二原发性恶性肿瘤问题的文献。此外，我们还回顾了脾脏隐匿性转移扩散以及全胃切除术中脾切除术的重要性。
