Pancreatic solitary and synchronous metastasis from breast cancer: a case report and systematic review of controversies in diagnosis and treatment

World Journal of Surgical Oncology

Guido De Sena²  Giacomo Cartenì¹  Maria Giuseppa Vitale¹  Giovanna Carrillo³  Martino Trunfio²  Ferdinando Riccardi¹  Antonio Braucci²  Carmela Mocerino¹  Carlo Molino² 

[1] Department of Oncology, Cardarelli Hospital, Naples, Italy;Department of General Surgery and Breast Unit, Cardarelli Hospital, Naples, Italy;Department of Pathology, Cardarelli Hospital, Naples, Italy

关键词: Mammaglobin;    Synchronous metastasis;    Pancreatic metastasis;    Lobular carcinoma;    Breast cancer;   

Others  :  820650
DOI  :  10.1186/1477-7819-12-2

 received in 2013-08-04, accepted in 2013-12-16,  发布年份 2014

【 摘 要 】

Background

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.

Case presentation

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.

Conclusions

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.

【 授权许可】

   
2014 Molino et al.; licensee BioMed Central Ltd.

【 图 表 】

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