Metastaze karcinoma dojke u konjunktivu

  • Anica Nedeljko Bobić Radovanović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Disease, Clinical Center of Serbia, Belgrade, Serbia
  • Dejan Rašić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Disease, Clinical Center of Serbia, Belgrade, Serbia
  • Marko Buta Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
  • Radan Džodić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.2298/1707
Ključne reči: conjunctiva||, ||konjunktiva, neoplasm metastasis||, ||neoplazme, metastaze, diagnosis||, ||dijagnoza, histological techniques||, ||histološke tehnike, breast neoplasms||, ||dojka, neoplazme,

Sažetak


Uvod. Metastaze u konjunktivu izuzetno su retke i, po pravilu, znak su uznapredovale maligne bolesti sa lošom prognozom. Prikazali smo bolesnicu sa metastazom karcinoma dojke u konjunktivu. Prikaz bolesnika. Bolesnica, stara 45 godina, pri dolasku imala je solitarnu, žućkastu, tanku i ograničenu leziju u gornjem nazalnom kvadrantu bulbarne konjunktive levog oka, koja je slučajno zapažena nedelju dana ranije. Nije bilo znakova iritacije niti bola, kao ni drugih funkcionalnih ni morfoloških problema u oku ili orbiti. Pet godina ranije dijagnostikovan je karcinom dojke. Bolesnica je lečena hemioterapijom, preoperativnom radioterapijom i urađena je radikalna mastektomija. Tri godine ranije, kompjuterizovanom tomografijom utvrđene su metastaze u levi hepatički lobus sa ascitesom i bolesnica je ponovo lečena hemioterapijom. Međutim, četiri meseca pre pojave konjunktivalne lezije, scintigrafijom su utvrđene multifokalne lezije u kostima dok su nuklearnom magnetnom rezonancom otkrivene difuzne metastaze u jetru i obostrano ovarijalni tumor. Sprovedena je palijativna radioterapija i hormonska terapija (megestrol, 160 mg). Urađena je ekscizijska biopsija uočene konjunktivalne lezije u lokalnoj anesteziji i materijal poslat na histopatološki pregled. Histopatološkim i imunohistohemijskim ispitivanjem utvrđena je metastaza infiltrišućeg lobularnog karcinoma dojke u konjunktivu. Stanje bolesnice nakon intervencije rapidno se pogoršavalo i umrla je nakon tri nedelje. Zaključak. S obzirom na to da je neočekivano i da do sada nije bilo registrovano, preživljavanje kraće od jednog meseca od pojave metastaze u konjunktivu zaslužuje posebnu pažnju. Nije uobičajeno da je histopatološka slika metastatske lezije toliko karakteristična da je na osnovu nje moguće definisati primarni tumor.

Biografije autora

Anica Nedeljko Bobić Radovanović, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Disease, Clinical Center of Serbia, Belgrade, Serbia
Clinic for eye disease CCS,
Dejan Rašić, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Disease, Clinical Center of Serbia, Belgrade, Serbia
Clinic for eye disease, CCS
Marko Buta, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Institute of oncology and radiology of Serbia
Radan Džodić, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Institute of oncology and radiology of Serbia

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Objavljeno
2017/01/19
Broj časopisa
Vol. 70 Br. 3 (2013)
Rubrika
Prikaz bolesnika