乳腺癌带状疱疹样皮肤转移1例并文献复习

Zosteriform Cutaneous Metastases from Breast Carcinoma:A Case Report and Literature Review

患者女,63岁。右乳腺癌术后1年半,右侧胸壁、腋下、背部红斑、结节伴疼痛1个月。皮肤科情况:右侧胸壁、腋下、背部皮肤片状红斑,有浸润感,散在多个红色质硬光亮结节,呈带状分布。红斑处组织病理示:表皮糜烂,真皮内大量肿瘤细胞浸润,肿瘤细胞多为圆形,细胞核淡染,中央可见核仁,细胞异型性明显。结节处组织病理示:表皮内基底层上方、真皮脉管内均可见肿瘤细胞巢,真皮深层肿瘤细胞浸润神经。免疫组织化学示:GATA-3、Mammaglobin、Ki-67阳性,AR弱阳性,ER、PR、Her-2阴性,符合乳腺来源。诊断:乳腺癌带状疱疹样皮肤转移。

A 63-year-old female presented with painful erythema and nodules on the right chest wall,axilla and back for one month.She had surgery of right breast cancer for a year and half.Physical examination revealed erythema and scattered red firm nodules,localized in a zosteriform pattern on the right chest wall,axilla and back.Histopathology of the erythema showed numerous round atypia tumor cells in the dermis.Histopathology of the nodule demonstrated nests of neoplastic cells in epidermis and the vessel,and the nerve were infiltrated by malignant cells.Immunohistochemical staining showed the tumor cells positive for GATA-3,Mammaglobin and Ki-67,weakly positive for AR,and negative for ER,PR and Her-2,which was consistent with metastatic breast carcinoma.This case was diagnosed as zosteriform cutaneous metastases from breast carcinoma and the patient underwent chemotherapy.