Treatment of single hepatic metastasis from surgically treated breast carcinoma. (Report of a clinical case and review of the literature)

In the natural history of the breast cancer, the liver metastatic location represents a clear element of an advanced stage of the disease, because it is often accompanied to multiple locations in the same organ and/or in different organs and tissues. The finding into two years after the primary intervention, during the ordinary follow-up, of an insulated metastasis in the 3rd hepatic segment in a patient operated for breast carcinoma, and the following surgical treatment of the metastasis, have suggested us to draft this note. The finding of a single metastasis in the liver in patients operated for breast carcinoma imposes a revaluation of the stage of sickness to highlight the contemporary presence of subsequent distance metastatic location; the negativity of the instrumental investigations performed has triggered the question about the type of therapeutic treatment to do to the patient. The range of therapeutic hypothesis spaces from the ultrasound guided mini-invasive techniques (alcoholization, infusion of LAK cells, use of radio frequencies), to the chemotherapy, so general that local one, by means of super selective catheterization of the hepatic artery, up to the, finally, minus usual (in these cases) surgical therapy. In the patient observed we have chosen the surgical treatment, consisting of a segmentary resection, we haven't any complication, neither intra- nor post-operative, and the patient was discharged in 8th day. Our choice of the surgical approach has bean consequence of an attentive evaluation so of the clinical indicators of the patient (good general conditions, bulk of the injury and surgical treatableness) that of the biological parameters of the neoplasm. The results of our experience, in line with whet indicated from the other AA., encourage the choice of the surgical treatment of the insulated hepatic metastasis from breast carcinoma, with the awareness of the concept of "adjuvant" that it necessarily engages in such circumstances, and, however, after an accurate selection of the patients.