PDF(Pubmed)
Abstract：
We present a case report of a 41-year-old woman who developed a left breast mass 18 months after undergoing Dixon rectal cancer surgery. The purpose of this case report is to highlight the possibility of breast metastases in patients with colorectal cancer and emphasize the importance of careful evaluation and follow-up as well as timely and accurate diagnosis and management of the metastatic disease. During the physical examination in 2021, we noted that the lower border of the mass was 9 cm from the anal verge and that it occupied approximately one-third of the intestinal lumen. A pathological biopsy revealed the mass in the patient\'s intestinal lumen was a rectal adenocarcinoma. The patient underwent Dixon surgery for rectal cancer and received subsequent chemotherapy. The patient had no prior history of breast-related medical conditions or a family history of breast cancer. During the current physical examination, we discovered multiple lymphadenopathies in the patient\'s left neck, bilateral axillae, and left inguinal region, but none elsewhere. We observed a large erythema of about 15x10 cm on the patient\'s left breast, with scattered hard nodes of varying sizes. Palpation of the area beyond the upper left breast revealed a mass measuring 3x3 cm. We conducted further examinations of the patient, which revealed the breast mass and lymphadenopathy on imaging. However, we did not find any other imaging that had significant diagnostic value. Based on the patient\'s conventional pathology and immunohistochemical findings, combined with the patient\'s past medical history, we strongly suspected that the patient\'s breast mass was of rectal origin. This was confirmed by the abdominal CT performed afterward. The patient was treated with a chemotherapy regimen consisting of irinotecan 260 mg, fluorouracil 2.25 g, and cetuximab 700 mg IV drip, which resulted in a favorable clinical response. This case illustrates that colorectal cancer can metastasize to unusual sites and underscores the importance of thorough evaluation and follow-up, particularly when symptoms are atypical. It also highlights the importance of timely and accurate diagnosis and management of metastatic disease to improve the patient\'s prognosis.
摘要：
我们提供了一例41岁女性的病例报告，该女性在接受Dixon直肠癌手术18个月后出现了左乳房肿块。本病例报告的目的是强调结直肠癌患者乳腺转移的可能性，并强调仔细评估和随访以及及时准确诊断和治疗转移性疾病的重要性。在2021年的体检中，我们注意到肿块的下边界距离肛门边缘9厘米，并且占据了肠腔的大约三分之一。病理活检显示患者肠腔内肿块为直肠腺癌。患者接受了Dixon手术治疗直肠癌，并接受了随后的化疗。患者既往无乳腺相关病史或乳腺癌家族史。在本次体检中,我们在病人的左颈部发现了多发性淋巴结病,双侧腋窝，和左侧腹股沟区，但没有其他地方。我们观察到患者左乳房有一个约15x10厘米的大红斑，具有不同大小的分散的硬节点。对左上乳房以外的区域的触诊显示出3x3cm的肿块。我们对病人进行了进一步的检查，成像显示乳腺肿块和淋巴结肿大。然而,我们没有发现任何其他具有重要诊断价值的影像学检查.根据患者的常规病理和免疫组织化学结果,结合患者的既往病史,我们强烈怀疑患者的乳房肿块是直肠起源的。随后进行的腹部CT证实了这一点。患者接受伊立替康260mg的化疗方案治疗，氟尿嘧啶2.25g,西妥昔单抗700毫克静脉滴注，这导致了良好的临床反应。这个案例说明结直肠癌可以转移到不寻常的部位，并强调了彻底评估和随访的重要性。特别是当症状不典型时。同时强调了及时准确诊断和治疗转移性疾病对改善患者预后的重要性。
