Sporadic breast metastasis derived from renal cell carcinoma: A case report.
Sporadic breast metastasis derived from renal cell carcinoma: A case report.
复制标题
DOI：
10.1016/j.eucr.2017.11.032
复制
发表时间：
2018-01
影响因子：
0.5
通讯作者：
Obara W
中科院分区：
文献类型：
--
作者：
Ikarashi D;Ishida K;Kashiwaba M;Kato Y;Shiomi E;Takayama M;Komatsu H;Takata R;Ohmori S;Sugai T;Obara W
3.乳腺外原发性恶性肿瘤转移到乳腺是罕见的。在各种临床尸检研究中，乳腺转移的发生率为5%至6.6%。[1]最常见的乳腺癌转移是恶性黑色素瘤、淋巴瘤、肺癌，男性中还有前列腺癌。2大约25%-30%的RCC患者在诊断时会出现转移性疾病。转移性肾细胞癌最常见的部位是肺、骨、局部淋巴结、肝和脑。肾细胞癌转移到乳房是罕见的。1942年首次报道肾癌转移到乳腺，文献中仅报道了25例。3其中11例以转移为首发症状，14例（其中2例为双侧）为既往肾切除后的异时性病变。肾细胞癌的转移是通过肿瘤细胞的血行和淋巴扩散到远处而发生的，由于肾脏淋巴引流的变化，这种转移通常以不可预测的方式发生。一般而言，RCC转移到乳腺的途径被认为是血行性的。4.免疫组化（如CD-10）检测原发灶、胰腺和转移灶，以明确原发灶转移，支持RCC的诊断。结果为胰腺阴性，因此，认为原发性为RCC。原发部位和转移部位D2-40 IHC检查均为阴性。基于这些结果，我们证实了肾细胞癌的乳腺转移途径是血行性的。
3. DiscussionMetastases to the breast from extramammary primary malignancies are rare. In various clinical autopsy studies, the incidence of metastasis to the breast ranges from 5% to 6.6%. 1 The most frequent metastases to the breast are from malignant melanoma, lymphoma, lung cancer, and, in men, prostatic cancer. 2 Approximately 25%–30% of patients with RCC will present with metastatic disease at the time of diagnosis. The most common sites of metastatic RCC are the lung, bone, regional lymph nodes, liver, and brain. Metastases to the breast from RCC are rare. First reported RCC metastasis to the breast in 1942, and only 25 cases have been reported in the literature. 3 Eleven of these cases presented with metastasis as the initial sign of the disease and 14, among which two were bilateral, occurred as metachronous lesions after a former nephrectomy. Metastasis of RCC occurs through hematogenous and lymphatic spread of tumor cells to distant sites, often in an unpredictable manner due to the varying lymphatic drainage of the kidney. In general, the pathway of RCC metastasis to the breast is considered to be hematogenous. 4 In order to confirm the primary site of metastasis, IHC, eg, CD-10, for the RCC primary, pancreas, and the metastatic site, supported the diagnosis of RCC. The results were negative for the pancreas, and therefore, the primary was considered to be RCC. The primary and metastatic sites were negative for D2-40 IHC examination. Based on these results, we confirmed that the metastatic pathway to the breast from RCC was hematogenous.