PDF(Pubmed)
Abstract：
Peritoneal metastasis from breast cancer is a relatively rare life-threatening condition. The gold standard for diagnosing peritoneal metastasis is a direct peritoneal biopsy. In this report, we describe an interesting case of peritoneal inflammation mimicking peritoneal metastasis in a patient with breast cancer, as confirmed by laparoscopic peritoneal biopsy. A 45-year-old woman with a history of right breast cancer presented with a peritoneal wall mass seen on an abdominal computed tomography (CT) in routine follow-up. She underwent right skin-sparing mastectomy with sentinel lymph node biopsy with direct to implant reconstruction 6 years prior and underwent right salpingo-oophorectomy 2 years before. Positron emission tomography-computed tomography (PET-CT) and abdominopelvic CT showed multiple enhancing nodules in small bowel mesentery and right peritoneal wall with a small amount of ascites, which led to a strong suspicion of peritoneal metastasis. After a multidisciplinary conference, the possibility of peritoneal seeding became doubtful. Laparoscopic biopsy was performed, and peritoneal wall mass biopsy was subsequently performed. Pathologic results showed no evidence of peritoneal metastasis of breast cancer. The peritoneal biopsy specimen revealed postoperative fibrosis and inflammation with some meal content. Although rare in breast cancer, peritoneal metastasis can produce a devastating outcome if left undiagnosed. Despite the imaging findings strongly suggesting metastasis, biopsy confirmation for the suspected lesion was necessary. This not only verifies true metastasis but also determines the treatment options available for the patient and thus unnecessary treatment can be avoided.
摘要：
乳腺癌的腹膜转移是一种相对罕见的危及生命的疾病。诊断腹膜转移的金标准是直接腹膜活检。在这份报告中,我们描述了一个有趣的情况下，腹膜炎症模仿腹膜转移的乳腺癌患者，经腹腔镜腹膜活检证实。一名45岁的女性，有右乳腺癌病史，在常规随访中在腹部计算机断层扫描（CT）上可见腹膜壁肿块。她在6年前接受了保留右侧皮肤的乳房切除术和前哨淋巴结活检，并直接进行了植入物重建，并在2年前接受了右侧输卵管卵巢切除术。正电子发射断层扫描-计算机断层扫描（PET-CT）和腹盆腔CT显示小肠系膜和右腹膜壁多发增强结节，少量腹水，这导致了对腹膜转移的强烈怀疑。在一个多学科会议之后,腹膜播种的可能性变得可疑。进行了腹腔镜活检，随后进行了腹膜壁肿块活检。病理结果无乳腺癌腹膜转移迹象。腹膜活检标本显示术后纤维化和炎症，并伴有一些膳食含量。虽然在乳腺癌中很少见，如果不确诊，腹膜转移会产生毁灭性的结果。尽管影像学发现强烈提示转移，对可疑病变进行活检确认是必要的.这不仅验证了真实的转移,而且确定了患者可用的治疗选择,因此可以避免不必要的治疗。
