Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report.
Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report.
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DOI：
10.1186/s13256-014-0511-6
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发表时间：
2015-02-14
影响因子：
1
通讯作者：
Yoshinaga K
中科院分区：
文献类型：
--
作者：
Toyoshima M;Iwahashi H;Shima T;Hayasaka A;Kudo T;Makino H;Igeta S;Matsuura R;Ishigaki N;Akagi K;Sakurada J;Suzuki H;Yoshinaga K
生殖器外癌的孤立性子宫转移非常罕见。乳腺癌是最常见的子宫体转移的原发部位，浸润性小叶癌比浸润性导管癌更容易扩散到妇科器官。一位62岁的绝经后日本妇女在20多年前被诊断为子宫平滑肌瘤，并一直保守治疗直到绝经。在她就诊前7年，她被诊断患有乳腺癌，并因IIA期浸润性小叶癌接受了右乳房部分切除术。她接受了辅助化疗，放疗和五年的阿那曲唑激素治疗。她的子宫肿块越来越大。她的肿瘤标志物水平在随访过程中明显升高，但全身检查仅显示一个孤立的子宫肿瘤。她接受了全腹子宫切除术和双侧输卵管卵巢切除术。组织病理学检查，包括详细的免疫组化，证实转移性浸润性小叶癌，浸润她的子宫肌层和纤维瘤组织。我们报告了一种非常罕见的浸润性小叶癌转移模式，并证明了总囊性病变液蛋白-15和mammaglobin在转移性乳腺癌的诊断中是有用的。
Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma. A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue. We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.