PDF(Pubmed)
Abstract：
Breast cancer is the most common malignancy diagnosed in women. Invasive lobular breast cancer (ILC) is the second most common histologic subtype after invasive ductal carcinoma. Metastatic occult primary breast cancer, although rare, is a well-known clinical entity that usually presents with axillary lymphadenopathy without a detectable breast tumour. A perimenopausal woman in her 50s presented with abdominal pain, fatigue, and weight loss. Imaging showed peritoneal carcinomatosis with ascites, ovarian masses, and a lesion in the ascending colon. Gastric and colon biopsies showed infiltration from lobular breast cancer. Diagnostic workup, including mammography, breast ultrasound, and breast MRI, showed no evidence of breast pathology or axillary lymphadenopathy. First-line treatment with goserelin, letrozole, and palbociclib commenced with clinical improvement and radiological response. This case illustrates the challenges faced by clinicians in the diagnosis and treatment of lobular breast cancer without an identifiable primary lesion or axillary lymphadenopathy.
摘要：
乳腺癌是女性最常见的恶性肿瘤。浸润性小叶乳腺癌（ILC）是仅次于浸润性导管癌的第二常见组织学亚型。转移性隐匿性原发性乳腺癌，虽然罕见，是一种众所周知的临床实体，通常表现为腋窝淋巴结病，而没有可检测的乳腺肿瘤。一名50多岁的围绝经期妇女出现腹痛，疲劳,和减肥。影像学显示腹膜癌伴腹水，卵巢肿块,升结肠有病变.胃和结肠活检显示小叶乳腺癌浸润。诊断检查,包括乳房X线照相术,乳腺超声,和乳腺核磁共振,没有乳腺病理或腋窝淋巴结病的证据。戈舍瑞林一线治疗,来曲唑,palbociclib开始改善临床和放射学反应。该病例说明了临床医生在诊断和治疗没有可识别的原发性病变或腋窝淋巴结肿大的小叶乳腺癌时面临的挑战。
