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George Tocu,1,* Ioana Teodora Popa,2 Iuliana Ivan,3 Lucretia Anghel,4 Luiza A Nechita,4 Carmina Liana Musat,5 Laura Florentina Rebegea,4,* Dana Tutunaru1,* 1Pharmaceutical Sciences Department, “Dunărea de Jos” University, Galati, Romania; 2Clinical Surgical Department, Fundeni Clinical Institute, Bucharest, Romania; 3Oncology Department of “Sf. Apostol Andrei” Emergency County Hospital, Galati, Romania; 4Clinical Medical Department, “Dunărea de Jos” University, Galati, Romania; 5Morphological and Functional Sciences Department, “Dunarea de Jos” University, Galati, Romania*These authors contributed equally to this workCorrespondence: George Tocu, Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40773819438, Email george_tocu@yahoo.comAbstract: Liver metastases are secondary malignant tumor formations due to the dissemination of primary malignant tumors, which are often the first clinical manifestation of mammary cancer. We present the case of a 52-year-old female patient from an urban area who came to the walk-in service at the “Sf. Ap. Andrei” Emergency County Hospital, Galati, for laboratory investigations. These revealed a significant increase in CA 15– 3 tumor markers and a slight increase in CA 125 and CA 19– 9 markers; however, clinical examination did not reveal tumors in the breast and there were no axillary adenopathies. CT exam revealed a large tumor formation in the hepatic right lobe and, close to it, a smaller one. The mammograph showed millimetric lesions at the level of the left mammary gland and bilateral axillary adenopathies. Subsequently, the patient underwent two liver biopsies in two different hospitals, which produced different histological and immunohistochemical results. PET-CT drew attention to a lung tumor and disclosed a different origin of metastases. In the end, correlating all investigations, the final diagnosis was cholangiocarcinoma with liver metastases and lung tumor with lung and bone metastases.Keywords: tumor, breast, biopsy, markers, immunohistochemistry |
