乳腺和胃双原发癌伴黑棘皮病1例报道并文献复习

Double Primary Cancers of the Breast and Stomach Associated with Acanthosis Nigricans: A Case Report and Literature Review

乳腺癌和胃癌均为常见恶性肿瘤,二者双原发病例临床较为罕见。恶性黑棘皮病是一种少见的恶性肿瘤的副肿瘤综合征。1临床病历资料患者女,58岁,8年前发现左乳肿块于外院行乳腺癌根治术。病理诊断为左乳腺浸润性导管癌(T2N0M0 IIa期),1年前行胃镜取检,病理回报“胃体部腺癌(中低分化)”。3个月前发现全身皮肤变黑、粗糙,伴瘙痒感。查体见全身皮肤粗糙,色素沉着,皮纹加深,以颈部、腋窝、腹股沟和外阴等褶皱部位皮肤为著,口唇、眼睑及手掌均呈天鹅绒样改变,未触及肿大淋巴结,左乳缺如呈术后改变,左上腹部可触及约5 * 5 cm包块,质硬,活动度差,轻压痛。心肺肝脾肾查体未见异常。

Breast cancer and gastric cancer are common malignant tumors, and the double primary cases of breast cancer and gastric cancer are rare in clinic. Malignant acanthosis nigricans is a rare paraneoplastic syndrome of malignant tumors. 1 clinical medical records the 58-year-old female patient who was found a mass in her left breast 8 years ago and underwent radical mastectomy in another hospital for breast cancer. The pathological diagnosis was left breast invasive ductal carcinoma (T2N0M0 stage IIa). One year before, the examination was performed under gastroscopy, and the pathological report was “gastric body adenocarcinoma (medium and low differentiation)”. 3 months ago, the skin of the whole body became black, rough and itchy. On rough skin, pigmentation, prints, such as the neck, armpits, groin, and genital fold for the skin, lips, eyelids and the palm of your hand in the velvet sample change, not hit swollen lymph nodes, the left breast is absent after change, upper left abdomen can hit about 5 * 5 cm bag piece, qualitative hard, poor mobility, light tenderness. Cardiopulmonary, liver, spleen and kidney examination showed no abnormality.