A rare recurrence of bilateral breast cancer in the esophagus coincidentally associated with primary gastric cancer: a case report.
A rare recurrence of bilateral breast cancer in the esophagus coincidentally associated with primary gastric cancer: a case report.
复制标题
DOI：
10.1186/1752-1947-8-58
复制
发表时间：
2014-02-18
影响因子：
1
通讯作者：
Hirakawa K
中科院分区：
文献类型：
--
作者：
Kashiwagi S;Onoda N;Asano Y;Noda S;Kawajiri H;Takashima T;Ishikawa T;Hirakawa K
乳腺癌食管转移的病例极为罕见。我们报告一位双侧乳癌治疗后复发为食道转移的病例。早期胃癌也是偶然发现的。一名有双侧乳腺癌病史的86岁日本女性患者在医学检查中发现胃肿块。在72岁时，她接受了全乳房切除术和II级腋窝淋巴结清扫术（pT3N0M0 II期）。79岁时发现左乳腺癌。进行全乳房切除术，并进行II级腋窝淋巴结清扫（pT1N0M0 I期）。在她目前入院时，我们的病人主诉吞咽困难。再次胃镜检查发现，在她的中食管粘膜下病变，位于27厘米远她的门牙，以及一个已知的I型肿瘤的贲门。计算机断层扫描显示她的食道中部有一个肿块病变，已经在腔外生长并浸润了气管分叉和左主支气管。在超音波监视下进行食道病灶钻孔活检，病理诊断为食道低分化腺癌。心脏病变的活组织检查显示为中度分化的胃腺癌。她的激素受体的表达状态表明，食管病变反映了她的乳腺癌转移性复发，同时原发性胃癌（cT1N0M0 IA期）。乳腺癌的食管转移是非常罕见的。因此，应根据患者的状况制定结合多模式方法的个性化治疗计划。
Cases of esophageal metastasis of breast cancer are extremely rare. We present the case of a patient who developed recurrence as esophageal metastasis following treatment of bilateral breast cancer. Early-stage gastric cancer was also found coincidentally. An 86-year-old Japanese female patient with a history of bilateral breast cancer was found to have a gastric mass on a medical examination. At 72 years of age, she had undergone a total mastectomy with level II axillary lymph node dissection (pT3N0M0 stage II). Left breast cancer was found at the age of 79. A total mastectomy was performed with level II axillary lymph node dissection (pT1N0M0 stage I). At the time of her current admission, our patient complained of dysphagia. A repeat gastrofiberscopy revealed a submucosal lesion in her middle esophagus, located 27cm distal to her incisors, as well as a known type I tumor of the gastric cardia. Computed tomography showed a mass lesion in her middle esophagus that had grown extraluminally and infiltrated the tracheal bifurcation and her left primary bronchus. A boring biopsy of the esophageal lesion was performed under ultrasonic monitoring, and a pathological diagnosis of poorly differentiated adenocarcinoma of the esophagus was obtained. The biopsy of the cardiac lesion revealed moderately differentiated adenocarcinoma of the stomach. The expression status of her hormone receptors indicated that the esophageal lesion reflected metastatic recurrence of her breast cancer with coincidental primary gastric cancer (cT1N0M0 stage IA). Esophageal metastasis of breast cancer is extremely rare. An individualized treatment plan combining multimodal approaches should therefore be devised according to the patient’s status.