内容紹介
Summary
A 76-year-old female underwent breast-conserving surgery of the right breast and sentinel lymph node biopsy for primary breast cancer. Three years later, mammography and ultrasonography showed a small nodule in the right breast. There was nothing abnormal in the left breast. Three months later, she complained of a huge and rapid growing mass in the left breast. Malignant cells were obtained on fine needle aspiration biopsy in the right breast tumor. But it was not possible to diagnose whether the left breast tumor was benign or malignant on fine needle aspiration biopsy and needle biopsy. Bilateral mastectomy and sentinel lymph node biopsy of the right side were performed. Pathological diagnosis were squamous cell carcinoma of the right breast and spindle cell carcinoma of the left breast. Although the patient was treated with adjuvant chemotherapy, she had an early relapse with pleural, lung and bone metastases. The patient died approximately 8 months after operation. Spindle cell carcinoma presents many problems about therapy and prognosis. Further accumulation analysis is necessary.
要旨
乳腺紡錘細胞癌は乳癌全体の1%未満といわれ,増殖速度が極めて速い。対側乳癌の術後観察中であったため,3か月という短期間に増大を確認することができ,術後化学療法中に再発を来して極めて急速な転帰をたどった症例を経験した。症例は76歳,女性。3年前に右乳癌に対してBp+SNを施行した。pT1,N0,M0,stageⅠ,ER(+),PgR(+),HER2(0),切除断端(-)で術後残存乳房照射(60 Gy)後,Letrozoleの内服を行っていた。3年後のマンモグラフィで右乳房に小腫瘤影を認めた。この時点で左乳房には異常所見を認めなかった。3か月後のフォロー時に右乳房の腫瘤はやや増大し,左乳房にも4 cm大の腫瘤を認めた。穿刺吸引細胞診で右乳癌の疑い,左乳房腫瘤に関しては針生検で間葉系腫瘍を疑い手術を施行した。術後病理診断の結果,右乳癌,squamous cell carcinoma,f,ly1,v1,NGⅡ,sn(-),ER(+),PgR(-),HER2(1+),左乳癌,spindle cell carcinoma,ly1,v1,NG Ⅲ,pNX,ER(-),PgR(-),HER2(0)であった。術後7か月の化学療法中に胸膜肺転移と骨転移を来し,加療を行ったが術後8か月で死亡した。
目次
A 76-year-old female underwent breast-conserving surgery of the right breast and sentinel lymph node biopsy for primary breast cancer. Three years later, mammography and ultrasonography showed a small nodule in the right breast. There was nothing abnormal in the left breast. Three months later, she complained of a huge and rapid growing mass in the left breast. Malignant cells were obtained on fine needle aspiration biopsy in the right breast tumor. But it was not possible to diagnose whether the left breast tumor was benign or malignant on fine needle aspiration biopsy and needle biopsy. Bilateral mastectomy and sentinel lymph node biopsy of the right side were performed. Pathological diagnosis were squamous cell carcinoma of the right breast and spindle cell carcinoma of the left breast. Although the patient was treated with adjuvant chemotherapy, she had an early relapse with pleural, lung and bone metastases. The patient died approximately 8 months after operation. Spindle cell carcinoma presents many problems about therapy and prognosis. Further accumulation analysis is necessary.
要旨
乳腺紡錘細胞癌は乳癌全体の1%未満といわれ,増殖速度が極めて速い。対側乳癌の術後観察中であったため,3か月という短期間に増大を確認することができ,術後化学療法中に再発を来して極めて急速な転帰をたどった症例を経験した。症例は76歳,女性。3年前に右乳癌に対してBp+SNを施行した。pT1,N0,M0,stageⅠ,ER(+),PgR(+),HER2(0),切除断端(-)で術後残存乳房照射(60 Gy)後,Letrozoleの内服を行っていた。3年後のマンモグラフィで右乳房に小腫瘤影を認めた。この時点で左乳房には異常所見を認めなかった。3か月後のフォロー時に右乳房の腫瘤はやや増大し,左乳房にも4 cm大の腫瘤を認めた。穿刺吸引細胞診で右乳癌の疑い,左乳房腫瘤に関しては針生検で間葉系腫瘍を疑い手術を施行した。術後病理診断の結果,右乳癌,squamous cell carcinoma,f,ly1,v1,NGⅡ,sn(-),ER(+),PgR(-),HER2(1+),左乳癌,spindle cell carcinoma,ly1,v1,NG Ⅲ,pNX,ER(-),PgR(-),HER2(0)であった。術後7か月の化学療法中に胸膜肺転移と骨転移を来し,加療を行ったが術後8か月で死亡した。