Deutsche medizinische Wochenschrift (1946) · 2009
[Diffuse mucosal gastric and coecal metastasis from occult breast cancer].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wagner J, Nerlich A, Schepp W
Аннотация
HISTORY AND CLINICAL FINDINGS: A slightly confused and apathic 78-year-old woman presented in a deteriorating general condition and unspecific symptoms with (diarrhea, vomiting, nausea).
INVESTIGATIONS: Laboratory tests revealed megalocytic anemia with vitamin B12 deficiency. As a cause, atrophic gastritis was suspected. Esophagogastroduodenoscopy with multiple "gastric mapping" biopsies revealed diffuse infiltration by an adenocarcinoma in 12 out of 14 gastric biopsy sites. Surprisingly, this malignant tissue was identified by immunohistochemistry as a diffuse infiltration by an as yet unrecognized breast cancer. Immunohistochemically identical infiltrations were identified in the cecum by colonoscopy.
TREATMENT AND COURSE: Subsequent mammography identified a retromammilar primary tumor in the right breast. Because of the patient's poor general condition merely palliative therapy with oral tamoxifen was initiated.
CONCLUSION: The correct diagnosis and appropriate therapy of gastric and coecal metastases secondary to an as yet unrecognized breast cancer were rendered possible only by additional immunohistochemical testing with specific antibodies against the estrogen receptor, cytoceratin (CK) 20 and 7 and E-cadherin.
INVESTIGATIONS: Laboratory tests revealed megalocytic anemia with vitamin B12 deficiency. As a cause, atrophic gastritis was suspected. Esophagogastroduodenoscopy with multiple "gastric mapping" biopsies revealed diffuse infiltration by an adenocarcinoma in 12 out of 14 gastric biopsy sites. Surprisingly, this malignant tissue was identified by immunohistochemistry as a diffuse infiltration by an as yet unrecognized breast cancer. Immunohistochemically identical infiltrations were identified in the cecum by colonoscopy.
TREATMENT AND COURSE: Subsequent mammography identified a retromammilar primary tumor in the right breast. Because of the patient's poor general condition merely palliative therapy with oral tamoxifen was initiated.
CONCLUSION: The correct diagnosis and appropriate therapy of gastric and coecal metastases secondary to an as yet unrecognized breast cancer were rendered possible only by additional immunohistochemical testing with specific antibodies against the estrogen receptor, cytoceratin (CK) 20 and 7 and E-cadherin.