PDF(Pubmed)
Abstract：
BACKGROUND: Esophageal involvement and Horner\'s syndrome are rare manifestations of breast cancer distant metastases that can pose a significant challenge in diagnosis and treatment. In addition to the more aggressive behavior of breast cancer diagnosed in young women, non-adherence to treatment is associated with increased risk of distant metastasis.
METHODS: A 36-year-old Javanese woman presented to our institution with dysphagia, hoarseness, and frequent hiccups. In the 6 weeks prior to the current admission, the patient also reported tingling in the neck and shoulder, anhidrosis in the left hemifacial region, and drooping of the upper left eyelid. She was previously managed as tuberculoid laryngitis. Plain X-rays showed burst fractures of the cervical vertebrae and slight pleural effusion. Laryngoscopy revealed bowing of the vocal cords and liquid residue in the vallecula that was reduced upon chin tuck. Esophageal metastasis was confirmed with endoscopy showing thickening of the wall and positive cytology swab with ductal malignant cells. The patient had a history of breast cancer with a period of loss to follow-up of 4 years.
CONCLUSIONS: Physicians should consider potential distant metastasis of breast cancer to the esophagus and sympathetic nervous system of the neck particularly in a high-risk woman with presentation of dysphagia and manifestations of Horner\'s syndrome.
METHODS: A 36-year-old Javanese woman presented to our institution with dysphagia, hoarseness, and frequent hiccups. In the 6 weeks prior to the current admission, the patient also reported tingling in the neck and shoulder, anhidrosis in the left hemifacial region, and drooping of the upper left eyelid. She was previously managed as tuberculoid laryngitis. Plain X-rays showed burst fractures of the cervical vertebrae and slight pleural effusion. Laryngoscopy revealed bowing of the vocal cords and liquid residue in the vallecula that was reduced upon chin tuck. Esophageal metastasis was confirmed with endoscopy showing thickening of the wall and positive cytology swab with ductal malignant cells. The patient had a history of breast cancer with a period of loss to follow-up of 4 years.
CONCLUSIONS: Physicians should consider potential distant metastasis of breast cancer to the esophagus and sympathetic nervous system of the neck particularly in a high-risk woman with presentation of dysphagia and manifestations of Horner\'s syndrome.
摘要：
背景：食管受累和霍纳综合征是乳腺癌远处转移的罕见表现，可能对诊断和治疗构成重大挑战。除了年轻女性诊断出的乳腺癌更具攻击性的行为外，不坚持治疗与远处转移风险增加相关.
方法：一名36岁的爪哇妇女出现吞咽困难，声音嘶哑,经常打嗝。在本次入院前的6周内，患者还报告颈部和肩部刺痛，左半面区域的无汗症，左上眼睑下垂。她以前是结核性喉炎。X线平片显示颈椎爆裂骨折和轻度胸腔积液。喉镜检查显示声带弯曲，并且在下巴褶皱后减少了声带的液体残留物。内镜检查证实食管转移，壁增厚，细胞学拭子阳性，导管恶性细胞。患者有乳腺癌病史，随访时间为4年。
结论：医生应考虑乳腺癌向食管和颈部交感神经系统的潜在远处转移，特别是在有吞咽困难和Horner综合征表现的高危女性中。
方法：一名36岁的爪哇妇女出现吞咽困难，声音嘶哑,经常打嗝。在本次入院前的6周内，患者还报告颈部和肩部刺痛，左半面区域的无汗症，左上眼睑下垂。她以前是结核性喉炎。X线平片显示颈椎爆裂骨折和轻度胸腔积液。喉镜检查显示声带弯曲，并且在下巴褶皱后减少了声带的液体残留物。内镜检查证实食管转移，壁增厚，细胞学拭子阳性，导管恶性细胞。患者有乳腺癌病史，随访时间为4年。
结论：医生应考虑乳腺癌向食管和颈部交感神经系统的潜在远处转移，特别是在有吞咽困难和Horner综合征表现的高危女性中。
