隐匿性乳腺癌的诊断、调查和治疗:病例报告和文献系统回顾

Nora Trabulsi , Sarah Almaghrabi , Basma Bamakhrama , Zahir Fadel , Alaa Shabkah , Ali Farsi , Basim Awan
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引用次数: 0

摘要

背景乳腺癌(OBC)是一种不常见的诊断,很少引起皮肤转移。我们的目的是报告一例伴有皮肤转移的 OBC 病例,并系统回顾目前有关此类病例的调查、诊断和治疗的证据。我们在 MEDLINE、Embase、Cochrane Library 和 Google Scholar 上进行了全面检索。我们纳入了从开始到 2022 年 8 月期间发表的、纳入了男性或女性 OBC 皮肤转移患者并报告了相关临床结果的英文研究。这些文章均为 2009 年至 2022 年间发表的病例报告,共纳入 13 例患者。最常见的皮损部位是胸部(7 例),其次是腋窝(5 例),其中 2 例为双侧皮损。5例患者的皮损为结节状,2例患者的皮损为斑丘疹状,2例患者的皮损为荨麻疹状,1例患者的皮损为丘疹状,2例患者的皮损为溃疡状。皮肤转移灶雌激素受体阳性 8 例,孕激素受体阳性 7 例,细胞角蛋白 7 阳性 6 例,GATA 结合蛋白 3 阳性 5 例。药物治疗主要是化疗(7 例)和激素治疗(3 例)。结论:在没有原发病灶的情况下发生皮肤乳腺转移是一种罕见现象。综述中的大多数病例都采用了包括手术和内科治疗在内的多模式治疗方法。本综述为遇到类似病例的医生提供了参考。
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Diagnosis, investigation, and treatment of occult breast cancer: A case report and systematic review of the literature

Background

Occult breast cancer (OBC) is an uncommon diagnosis that rarely causes skin metastasis. Our aim herein was to report a case of OBC with cutaneous metastasis and to systematically review the current evidence on the investigation, diagnosis, and treatment of such cases.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was conducted on MEDLINE, Embase, Cochrane Library, and Google Scholar. We included studies in English published from inception to August 2022 that included male or female patients who presented with OBC metastasis to the skin and that reported clinical outcomes of interest.

Results

We identified 854 articles, 13 of which were included in our review. The articles were case reports published between 2009 and 2022 and included 13 patients. The commonest site for skin lesions was the chest (n = 7), followed by the axilla (n = 5), of which 2 were bilateral. The skin lesions were nodular in 5 cases, macular in 2 cases, urticarial in 2 cases, papular in 1 case, and ulcerating in 2 cases. Skin metastasis was positive for estrogen receptor in 8 cases, progesterone receptor in 7 cases, cytokeratin 7 in 6 cases, and GATA binding protein 3 in 5 cases. Medical management was mostly by chemotherapy (n = 7) and hormonal therapy (n = 3). Surgical excision of the skin lesion was performed in 5 cases.

Conclusion

Cutaneous breast metastasis in the absence of the primary lesion is a rare phenomenon. Most cases reviewed were managed with multimodal approach including surgical and medical management. This review provides reference for physicians coming across similar cases.

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