Metastatic Carcinoma Breast Presenting as Appendicular Abscess
Metastatic Carcinoma Breast Presenting as Appendicular Abscess
复制标题
DOI：
10.7860/jcdr/2021/44398.14412
复制
发表时间：
2021-01-01
影响因子：
0.2
通讯作者：
Gharde, Pankaj
中科院分区：
文献类型：
--
作者：
Yeola (Pate), Meenakshi;Singh, Kushagra;Gharde, Pankaj
乳腺癌是世界范围内女性最常见的癌症，主要表现为乳房中的无痛硬块。作者报告了1例59岁女性患者，因右侧髂窝疼痛和肿块、高热伴寒战和寒战、多次呕吐就诊于急诊室。她发热，心动过速，血压正常。检查发现右髂窝有一个坚硬的压痛肿块，伴腹部保护。意外发现一个大的左侧乳房肿块。放射学检查显示脓肿。她进行了紧急诊断性腹腔镜检查，随后进行了阑尾切除术。令人惊讶的是，组织病理学显示阑尾导管癌的沉积。她在切口部位出现粪瘘。在进一步评估左乳房肿块时，诊断为局部晚期乳腺癌。患者接受新辅助化疗，随后接受左侧改良根治性乳房切除术（MRM）和辅助化疗。从那时起，她就定期接受随访。乳腺肿瘤的包膜转移是一种罕见的转移部位，其临床表现为包膜脓肿，给诊断和治疗带来了挑战。
Breast cancer is the most common cancer in females worldwide and presents mostly as a hard painless lump in breast. Authors report a case of a 59-year-old female who presented to emergency department with complaints of pain and lump in right iliac fossa, high grade fever with chills and rigor, multiple episodes of vomiting. She was febrile having tachycardia with normal blood pressure. Examination revealed a firm tender lump in right iliac fossa with guarding of abdomen. Incidental finding of a large left sided breast lump was noted. Radiological investigations revealed appendicular abscess. She was undertaken for emergency diagnostic laparoscopy followed by appendectomy. Surprisingly, histopathology revealed deposits of ductal carcinoma in appendix. She developed faecal fistula at incision site. On further evaluation of left breast lump it was diagnosed as locally advanced breast carcinoma. Patient was managed with neo-adjuvant chemotherapy followed by left sided Modified Radical Mastectomy (MRM) and adjuvant chemotherapy. She was on regular follow- up since then. Appendicular metastasis is one of the rare sites of metastasis of breast malignancy and presentation as appendicular abscess made the diagnosis and management challenging.