癌症腹部转移——一种不寻常实体的临床特征。

András Drozgyik, F Tamás Molnár, Zsófia Tokodi, György Bodoky, Dániel Kollár, Attila Oláh
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摘要

病例报告:一名六十五岁的女性患者因严重的胃肠道症状接受了手术,随后出现了令人担忧的CT图像。剖腹探查发现不可切除的胃癌和腹膜癌。行姑息性胃空肠吻合术和回肠下端吻合术。内窥镜诊断-可塑性结缔组织炎-和术中肉眼表现符合并同意组织学上假定的志贺细胞癌。在最初的腹部症状出现三年后,从肿瘤姑息治疗期间新发现的皮肤转移瘤中提取的组织学样本证实了隐匿小叶性乳腺癌。腹部探查标本的组织学检查证实了后一种诊断。激素受体阳性、人表皮生长因子受体-2阴性的恶性肿瘤在姑息性激素治疗中表现出很好的消退。讨论:约10%的乳腺癌病例为小叶癌,多为多中心、双侧、隐匿性,易转移至浆膜、腹腔和盆腔脏器。由于乳腺癌患者生存率的提高,预计乳腺癌腹部转移的数量将会增加。组织学证实是必不可少的,即使是晚期腹部恶性肿瘤,特别是在一个不寻常的病史的情况下。目前罕见的病例表明需要在乳腺癌的所有诊断和治疗领域进行多学科合作。
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Emlőrák hasüregi áttétei - Egy szokatlan entitás klinikopatológiai jellemzői.

Case report: A sixty-five-year-old female patient underwent surgery for severe gastrointestinal symptoms, following an alarming CT image. Laparotomy revealed irresectable gastric cancer and peritoneal carcinosis. Palliative gastro-jejunostomy and ileo-descendostomy were performed. The endoscopic diagnosis - linitis plastica - and the intraoperative macroscopic appearance matched and agreed on the histologically presumed shigillocellular carcinoma. Three years following the initial abdominal symptoms, histological samples taken from newly detected cutaneous metastases which developed during oncological palliative treatment verified occult lobular breast carcinoma. Histological revision of the sample taken from abdominal exploration confirmed the latter diagnosis. The hormone receptor positive, human epidermal growth factor receptor-2 negative malignancy showed very good regression for the palliative hormone treatment.

Discussion: About ten percent of breast cancer cases are lobular carcinomas, which are more often multicentric, bilateral, occult and have a propensity to metastasize to serous membranes, abdominal and pelvic viscera. Due to the increasing survival of breast cancer patients, the number of abdominal metastases of breast cancer is expected to increase. Histological confirmation is indispensable even in case of advanced abdominal malignancies, especially in the case of an unusual medical history. The currently rare case demonstrates the need for multidisciplinary cooperation in all diagnostic and therapeutic fields of breast cancer.

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