Abstract
Amaç: Meme kanseri sıklıkla akciğer, karaciğer, kemik ve beyin gibi organlara metastaz yapar. Ekstragenital metastazlarından
daha az sıklıkta genital organlara metastaz yapmaktadır. Genital organlardan en sık overlere metastaz yapar, uterusa ve servikse
metastazı ise oldukça nadir olarak bildirilmektedir. Meme kanserinin nüksü sıklıkla ilk 2 yılda görülmektedir, sıklığı giderek düşmekle
beraber nüks olasılığı hiçbir zaman ortadan kalkmamaktadır. Bu yazıda meme kanseri nedeniyle cerrahi tedavi sonrası
adjuvan radyoterapi ve kemoterapi alan hastada 20 yıl sonra over, endometrium ve servikste gelişen nüks olgusu sunulmuştur.
Olgu Sunumu: 65 yaşında postmenopozal hasta karın ağrısı ve şişliği yakınması ile kliniğimize başvurdu. Hasta 20 yıl önce modifiye
radikal mastektomi ile aksiler lenf diseksiyonu ve sonrasında adjuvant radyoterapi ve kemoterapi öyküsü vermekteydi. Muayene
ve görüntüleme yöntemleri ile sağ overde tümöral kitle ile peritonitis karsinomatoza tablosu ortaya konuldu. Ca125:1294
U/mL, Ca199:36 U/mL, Ca153:86 U/mL olarak saptandı. Endometrial örnekleme sonucu endometrial polip zemininde meme kanseri
metastazı saptandı. Abdominal total histerektomi, bilateral salpingoooferektomi ve omentektomi yapıldı. Frozen incelemede
overdeki kitlenin meme kanserinin metastazı olduğu saptanması nedeniyle cerrahi evreleme yapılmadı. Histopatolojik ve immunohistokimyasal
olarak her iki over ve tuba uterina, serviks, endometrium, omentum ve periton biopsilerinde meme kanseri
metastazı tanısı doğrulandı.
Sonuç: Öyküsünde meme kanseri olan hastaların değerlendirilmesinde, meme kanserinin nüks olasılığının adjuvan tedavi tamamlandıktan
sonra geçen zamanla giderek azalmakla birlikte hiçbir zaman ortadan kalkmadığı akılda tutulmalıdır
Keywords
References
- 1. Scopa CD, Aletra C, Lifschitz-Mercer B et al. Metastases of breast carcinoma to the uterus. Report of two cases, one harboring a primary endometrioid carcinoma, with review of the literature. Gynecol Oncol. 2005;96:543-547.
- 2. Ustaalioglu BB, Bilici A, Seker M et al. Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy. Onkologie. 2009;32:424-426.
- 3. M. T. Mazur, S. Hsueh, and D. J. Gersell. Metastases to the female genital tract; Analysis of 325 cases. Cancer. 1984;53:1978–1984.
- 4. B. Piura, I. Yanai-Inbar, A. Rabinovich, S. Zalmanov, and J. Goldstein. Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy. European Journal of Obstetrics Gynecology and Reproductive Biology. 1999;83:57–61.
- 5. Brewster A.M, Hortobagyi G.N, Broglio K.R et al. Residual Risk of Breast Cancer Recurrence 5 Years After Adjuvant Therapy. J Natl Cancer Inst 2008;100:1179 –1183.
Abstract
Aim: Breast cancer often metastasizes to lung, liver, bone and brain. Genital metastasis is less frequent compared with extra genital
metastasis. Ovaries are the most affected sites among the genital metastases while uterine and cervical metastases are rare.
Recurrence of breast cancer usually occurs at the first 2 years. The incidence of recurrence decreases over time, however never
completely disappears. In this report, a patient with a recurrent invasive ductal breast carcinoma after 20 years at the ovaries,
endometrium, and cervix has presented.
Case Presentation: A 65-year-old patient presented with postmenopausal abdominal pain and distension. She was diagnosed
with breast carcinoma 20 years ago and had a history of modified radical mastectomy with axillary lymph node dissection, adjuvant
radiotherapy and chemotherapy. Gynecological examination and radiological exposed to a tumoral mass at the right ovary
and peritonitis carcinomatosis. Each serum tumor marker levels were; CA125: 1294 U / mL, Ca199: 36 U / ml, Ca153: 86 U / ml
respectively. Endometrial sampling revealed breast carcinoma metastasis in the basis of endometrial polyp. She underwent total
abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy. Breast carcinoma metastasis was diagnosed by
frozen section thereby surgical staging was not performed. Bilateral adnexial, peritoneal, endometrial and cervical metastasis was
confirmed histopathologically and immunohistochemically.
Conclusion: The likelihood of recurrence gradually decreases after completion of adjuvant therapy but it should be kept in mind
that it never disappears
Keywords
References
- 1. Scopa CD, Aletra C, Lifschitz-Mercer B et al. Metastases of breast carcinoma to the uterus. Report of two cases, one harboring a primary endometrioid carcinoma, with review of the literature. Gynecol Oncol. 2005;96:543-547.
- 2. Ustaalioglu BB, Bilici A, Seker M et al. Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy. Onkologie. 2009;32:424-426.
- 3. M. T. Mazur, S. Hsueh, and D. J. Gersell. Metastases to the female genital tract; Analysis of 325 cases. Cancer. 1984;53:1978–1984.
- 4. B. Piura, I. Yanai-Inbar, A. Rabinovich, S. Zalmanov, and J. Goldstein. Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy. European Journal of Obstetrics Gynecology and Reproductive Biology. 1999;83:57–61.
- 5. Brewster A.M, Hortobagyi G.N, Broglio K.R et al. Residual Risk of Breast Cancer Recurrence 5 Years After Adjuvant Therapy. J Natl Cancer Inst 2008;100:1179 –1183.
Details
| Other ID | JA89YE76BR |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | October 1, 2014 |
| Submission Date | October 1, 2014 |
| Published in Issue | Year 2014 Volume: 17 Issue: 4 |