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

Case Report

Guido De Sena¹  Antonio Braucci¹  Carlo Molino¹  Martino Trunfio¹  Giacomo Cartenì²  Ferdinando Riccardi²  Maria Giuseppa Vitale²  Carmela Mocerino²  Giovanna Carrillo³ 

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

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

DOI  :  10.1186/1477-7819-12-2

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

来源: Springer

【 摘 要 】

BackgroundMetastases 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 presentationA 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.ConclusionsThis 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】

Unknown   
© Molino et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.