Metastaze karcinoma dojke u želudac i debelo crijevo: prikaz dviju bolesnica [Breast cancer metastases to the stomach and colon: two case reports]

Pulanić, Roland and Jelavić, Marko and Premužić, Marina and Opačić, Milorad and Jakić-Razumović, Jasminka and Padovan-Štern, Ranka and Vrbanec, Damir (2012) Metastaze karcinoma dojke u želudac i debelo crijevo: prikaz dviju bolesnica [Breast cancer metastases to the stomach and colon: two case reports]. Liječnički vjesnik, 134 (5-6). pp. 159-163. ISSN 0024-3477

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Abstract

Breast cancer has a high potential for metastasis, usually to the lungs, bones, liver and lymph nodes. Metastases in the holow organs of the digestive system are rare and mainly affectes the stomach and colon. They are characterized by very different clinical and radiological manifestations. We have warned that the initial unrecognized breast cancer can appear as a primary tumor of the stomach and colon, and onlya histopathological analysis reveales that it is a metastatic breast cancer. Metastases to the stomach or intestine involve deep layer of the mucosa and pathohistological findings of standard biopsy sample can be falsely negative, despite positive imaging technique (abdominal ultrasound and MSCT, endoscopic ultrasound) that indicate the tumor process. That's,why we emphasize the importance of endoscopic mucosal resection in the detection of malignant process of deeper layers of the gastric mucosa and deep intestinal mucosal biopsies with postoperative analysis of its walls.

Abstract in Croatian

Karcinom dojke ima visok potencijal metastaziranja, i to najčešće u pluća, kosti, jetru i limfne čvorove. Metastaze u šuplje organe probavnog sustava rijetke su i uglavnom zahvaćaju želudac i debelo crijevo. Karakterizirane su vrlo različitim kliničkim i radiološkim manifestacijama. Prikazom dviju bolesnica upozorili smo na to da se inicijalno neprepoznat karcinom dojke može primarno prikazati kao tumor želuca i debelog crijeva, a tek patohistološka analiza dubljih slojeva sluznice tih organa otkriva da se radi o metastazama karcinoma dojke. Metastaze u želudac ili crijevo zahvaćaju duboki sloj sluznice pa patohistološki nalaz standardnoga bioptičkog uzorka može biti lažno negativan, unatoč pozitivnim slikovnim metodama (UZ i MSCT abdomena, endoskopski ultrazvuk) koje upućuju na tumorski proces. Zato ističemo važnost endoskopske mukozne resekcije u detekciji malignog procesa dubljih slojeva sluznice želuca te duboke biopsije crijevne sluznice i postoperativne analize njegove stijenke.

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