Breast cancer metastasis to the stomach may mimic primary gastric cancer: report of two cases and review of literature.
Breast cancer metastasis to the stomach may mimic primary gastric cancer: report of two cases and review of literature.
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DOI：
10.1186/1477-7819-5-75
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发表时间：
2007-07-09
影响因子：
3.2
通讯作者：
Mason, Robert C
中科院分区：
文献类型：
--
作者：
Jones, Gregory E;Strauss, Dirk C;Mason, Robert C
背景：胃是乳腺癌转移的罕见部位。根据临床、内窥镜、放射学和组织病理学特征，可能很难区分乳腺癌胃转移和原发性胃癌。重要的是，使这种区别的基础上，乳腺癌转移到胃的治疗通常是全身治疗，而不是surgical.CASE介绍：第一个病人，一个51岁的女人，开发了一个明显的局部印戒胃腺癌3年后治疗小叶乳腺癌没有复发的临床证据。最初的胃活组织检查雌激素和孕激素受体均为阴性。D2全胃切除术后的组织学报告为T4 N3 Mx。大体囊性疾病液蛋白免疫组化呈阳性，提示转移性乳腺癌。第二位患者是一位61岁的女性，在乳腺癌初始治疗后14年发生了近端胃印戒腺癌，随后复发并伴有骨和胸膜转移。在这种情况下，最初的胃活检是积极的雌激素和孕激素受体;随后的调查显示广泛的转移和手术是avoided.CONCLUSION：在乳腺癌的病史的患者，一个高度的怀疑指数，潜在的乳腺癌转移到胃应保持新的胃肠道症状的发展或明显的原发性胃癌被诊断。完整的组织病理学和免疫组化分析的胃活检和比较与原来的乳腺癌病理是重要的。
BACKGROUND: The stomach is an infrequent site of breast cancer metastasis. It may prove very difficult to distinguish a breast cancer metastasis to the stomach from a primary gastric cancer on the basis of clinical, endoscopic, radiological and histopathological features. It is important to make this distinction as the basis of treatment for breast cancer metastasis to the stomach is usually with systemic therapies rather than surgery.CASE PRESENTATIONS: The first patient, a 51 year old woman, developed an apparently localised signet-ring gastric adenocarcinoma 3 years after treatment for lobular breast cancer with no clinical evidence of recurrence. Initial gastric biopsies were negative for both oestrogen and progesterone receptors. Histopathology after a D2 total gastrectomy was reported as T4 N3 Mx. Immunohistochemistry for Gross Cystic Disease Fluid Protein was positive, suggesting metastatic breast cancer. The second patient, a 61 year old woman, developed a proximal gastric signet-ring adenocarcinoma 14 years after initial treatment for breast cancer which had subsequently recurred with bony and pleural metastases. In this case, initial gastric biopsies were positive for both oestrogen and progesterone receptors; subsequent investigations revealed widespread metastases and surgery was avoided.CONCLUSION: In patients with a history of breast cancer, a high index of suspicion for potential breast cancer metastasis to the stomach should be maintained when new gastrointestinal symptoms develop or an apparent primary gastric cancer is diagnosed. Complete histopathological and immunohistochemical analysis of the gastric biopsies and comparison with the original breast cancer pathology is important.