Acute Appendicitis and Small Bowel Obstruction Secondary to Metastatic Breast Cancer
Acute Appendicitis and Small Bowel Obstruction Secondary to Metastatic Breast Cancer
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DOI：
10.7759/cureus.4706
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发表时间：
2019-05-21
影响因子：
1.2
通讯作者：
Abughanimeh, Omar
中科院分区：
文献类型：
--
作者：
Numan, Laith;Asif, Samia;Abughanimeh, Omar
乳腺癌是女性中最常见的癌症;众所周知，它会转移到淋巴结、肺、肝、脑和骨骼。然而，胃肠道转移是罕见的，尤其是阑尾。在此，我们报告一个癌症转移到回肠和阑尾，导致急性阑尾炎和小肠梗阻的病例。这是一位44岁女性，有IV期转移性乳腺癌到骨、肺和卵巢的病史，出现急性腹痛一天。她的腹部柔软，肿胀，有普遍的压痛。腹部和骨盆的计算机断层扫描（CT）显示部分小肠梗阻和阑尾肿胀。保守治疗后症状恶化，患者被送往手术室，发现回肠明显扩张，有急性阑尾炎体征，因此接受了回盲部切除术、阑尾切除术和粘连松解术。病理学检查显示阑尾转移性乳腺癌，结果与急性阑尾炎一致。她对手术耐受良好，无并发症。总之，乳腺癌的小肠和阑尾转移是非常罕见的，但他们应考虑在鉴别诊断癌症患者出现急性腹痛。
Breast cancer is the most common cancer in women; it is well-known to metastasize to lymph nodes, lungs, liver, brain, and bones. However, luminal gastrointestinal metastasis is rare, especially to the appendix. Herein, we report a case where cancer metastasized to the ileum and appendix, causing acute appendicitis and small bowel obstruction. This is a 44-year-old female with a history of stage IV metastatic breast cancer to bones, lungs, and ovaries, presented with acute abdominal pain for one day. Her abdomen was soft, distended with generalized tenderness. Computed tomography (CT) of the abdomen and pelvis showed a partial small bowel obstruction and swollen appendix. After her symptoms worsened on conservative treatment, she was taken to the operating room where she was found to have a markedly dilated ileum with signs of acute appendicitis, so she underwent ileocecectomy, appendectomy, and lysis of adhesions. Pathology showed metastatic breast cancer in the appendix with findings consistent with acute appendicitis. She tolerated surgery well without complications. In conclusion, small intestinal and appendiceal metastases of breast cancer are very rare though they should be considered in the differential diagnosis in cancer patients presenting with acute abdominal pain.