Colonic metastasis from breast carcinoma detection by CESM and PET/CT: A case report
Colonic metastasis from breast carcinoma detection by CESM and PET/CT: A case report
复制标题
DOI：
10.1097/md.0000000000010888
复制
发表时间：
2018-05-01
期刊：
影响因子：
1.6
通讯作者：
Ferrari, Guglielmo
中科院分区：
文献类型：
--
作者：
Falco, Giuseppe;Mele, Simone;Ferrari, Guglielmo
简介：乳腺浸润性小叶癌（ILC）的转移扩散主要发生在骨骼、妇科器官、腹膜、腹膜后和胃肠道（GI）。胃肠道转移可能会在初次诊断后多年发生，并可能影响从舌头到肛门的消化道，胃是最常受累的部位。临床表现主要是非特异性的，很少无症状。 CEA、CA 15-3 和 CA 19-9 可能对既往有乳腺癌病史的有症状患者提供信息。 病例介绍：我们介绍一例 Luminal A ILC 随访的 67 岁女性乳腺癌无症状结肠转移病例。通过正电子发射断层扫描/计算机断层扫描 (PET/CT) 扫描和对比增强能谱乳房 X 线摄影 (CESM) 进行诊断，指导内窥镜医师发现受累肠道并排除乳腺实质中的进一步播散。结论：在结肠转移中，肿瘤标志物可能并不完全可靠。在无症状病例中，临床状况可能被低估，错过局部或远处复发。 CT 和 PET/CT 扫描可能有助于诊断小体积疾病，并引导内窥镜医师寻找源自乳房的胃肠道转移。 CESM 代表了一种可容忍且可行的工具，可以排除乳房定位的多中心性和多焦点性。此外，特定患者对它的耐受性比磁共振成像（MRI）更好。
Introduction:Metastatic spread in invasive lobular carcinoma (ILC) of breast mainly occurs in bones, gynecological organs, peritoneum, retroperitoneum, and gastrointestinal (GI) tract. Metastases to the GI tract may arise many years after initial diagnosis and can affect the tract from the tongue to the anus, stomach being the most commonly involved site. Clinical presentations are predominantly nonspecific, and rarely asymptomatic. CEA, CA 15-3, and CA 19-9 may be informative for symptomatic patients who have had a previous history of breast cancer.Case presentation:We introduce the case of asymptomatic colonic metastasis from breast carcinoma in a 67-year-old woman followed-up for Luminal A ILC. Diagnosis was performed through positron emission tomography/computed tomography (PET/CT) scan and contrast-enhancement spectral mammography (CESM), steering endoscopist to spot the involved intestinal tract and in ruling out further dissemination in the breast parenchyma.Conclusion:In colonic metastases, tumor markers might not be totally reliable. In asymptomatic cases, clinical conditions might be underappreciated, missing local or distant recurrence. CT and PET/CT scan might be useful in diagnosing small volume diseases, and steering endoscopist toward GI metastasis originating from the breast. CESM represents a tolerable and feasible tool that rules out multicentricity and multifocality of breast localization. Moreover, particular patients could tolerate it better than magnetic resonance imaging (MRI).