Pancreatic solitary and synchronous metastasis from breast cancer: a case report and systematic review of controversies in diagnosis and treatment.
Pancreatic solitary and synchronous metastasis from breast cancer: a case report and systematic review of controversies in diagnosis and treatment.
复制标题
DOI：
10.1186/1477-7819-12-2
复制
发表时间：
2014-01-05
影响因子：
3.2
通讯作者：
Breast Unit Cardarelli Hospital, Naples, Italy
中科院分区：
文献类型：
--
作者：
Molino C;Mocerino C;Braucci A;Riccardi F;Trunfio M;Carrillo G;Vitale MG;Cartenì G;De Sena G;Breast Unit Cardarelli Hospital, Naples, Italy
乳腺癌的转移导致肺、骨、肝和脑的频繁受累，而胃肠道转移的发生是罕见的，并且在乳腺癌的初步诊断后更频繁地发现。乳腺癌的孤立性胰腺转移，没有广泛的疾病，实际上是罕见的，只有19例已被描述过;真正例外的是一个孤立的胰腺转移变得明显与原发性乳腺癌。一名68岁的女性报告全身疲劳、嗜睡和黄疸。腹部超音波及磁振造影显示为乏特氏乳头壶腹瘤，并诊断为左乳肿瘤性结节。她接受了乳腺癌和乏特乳头壶腹瘤的手术。胰腺标本的病理检查，然而，并没有确认原发性癌的十二指肠乳头，但显示转移参与胰腺小叶乳腺癌。免疫组化对确认恶性肿瘤的起源是必不可少的：激素受体和乳腺珠蛋白在原发性乳腺肿瘤和胰腺转移瘤中都有表达。这是文献中少数报道的乳腺癌孤立性和同步性胰腺转移病例之一，仅在手术后获得明确诊断。我们讨论了这种诊断的争议和正确治疗的选择。孤立性转移瘤的手术切除可以在没有播散性疾病的情况下进行。
Metastases from breast cancer cause the frequent involvement of lung, bone, liver, and brain, while the occurrence of metastases to the gastrointestinal tract is rare, and more frequently discovered after a primary diagnosis of breast cancer. Solitary pancreatic metastases from breast cancer, without widespread disease, are actually unusual, and only 19 cases have been previously described; truly exceptional is a solitary pancreatic metastasis becoming evident together with the primary breast cancer. A 68-year-old woman reported general fatigue, lethargy, and jaundice. Abdominal ultrasound (US) and magnetic resonance imaging (MRI) showed an ampulloma of Vater’s papilla; moreover, a neoplastic nodule in the left breast was diagnosed. She underwent surgery for both breast cancer and ampulloma of Vater’s papilla. Pathological examination of pancreatic specimen, however, did not confirm primary carcinoma of the duodenal papilla, but showed a metastatic involvement of pancreas from lobular breast cancer. Immunohistochemistry has been essential to confirm the origin of the malignancy: hormone receptors and mammaglobin were expressed in both the primary breast tumor and the pancreatic metastasis. This is one of the few reported cases in literature of an isolated and synchronous pancreatic metastasis from breast cancer, where the definitive diagnosis was obtained only after surgery. We discuss the controversies in this diagnosis and the choice of correct treatment. The surgical resection of solitary metastases can be performed in the absence of disseminated disease.
登录
查看更多内容
影响因子：
254.7
作者：
Jemal, Ahmedin;Siegel, Rebecca;Thun, Michael J.
通讯作者：
Thun, Michael J.
影响因子：
2.1
作者：
Ascenti, G;Visalli, C;Mazziotti, S
通讯作者：
Mazziotti, S
影响因子：
1.3
作者：
BOUDGHENE, FP;DESLANDES, PM;BIGOT, JMR
通讯作者：
BIGOT, JMR
影响因子：
3.3
作者：
Bratthauer, GL;Moinfar, F;Tavassoli, FA
通讯作者：
Tavassoli, FA
影响因子：
5.5
作者：
Klein, KA;Stephens, DH;Welch, TJ
通讯作者：
Welch, TJ