内容紹介
Summary
The patient was a 50-year-old woman. She had been diagnosed with bilateral breast tumors at another hospital 5 years previously and was followed up every 2 months. Ultrasonography showed hypoechoic masses in her breasts. The largest tumor in the right breast was 15 mm in diameter and located in region A, while that in the left breast was 8 mm in diameter and located in region B. Magnetic resonance imaging(MRI)showed multiple bilateral breast tumors. The largest tumor was 12 mm in diameter and was suggestive of breast cancer. Core needle biopsies(CNB)of the largest tumors in both breasts were performed. Intraductal papilloma(IDP)and low-grade intraductal papillary carcinoma were diagnosed in the right and left breasts, respectively, on immunohistochemical staining. We performed left nipple-sparing mastectomy with sentinel lymph node biopsy and right tumor excision for diagnoses of carcinoma of the left breast(cTisN0M0)and IDP of the right breast. The histopathological diagnosis of the left breast tumor was pT1aN0M0, triple negative breast cancer with extensive intraductal components, and that of the right breast tumor was IDP with atypical ductal hyperplasia. Chemotherapy was administered postoperatively. Several studies have reported that peripheral IDP often coexists with or follows the development of carcinoma. Therefore, we should also closely follow-up the patient's right breast.
要旨
症例は50歳,女性。5年前から他院で両側乳房腫瘤を指摘され,2か月ごとのfollowとなっていた。超音波検査では,右側は最大15 mm(A領域),左側は最大8 mm(B領域)の低エコー腫瘤が散発しており,乳房MRIでは両側に最大12 mmの腫瘤を多数認め,乳癌が否定できない所見であった。両側最大径の腫瘤に対し針生検を施行したところ,免疫染色にて右側は乳管内乳頭腫,左側は乳管内乳頭癌と診断された。左乳癌,cTisN0M0,右乳管内乳頭腫の診断で左乳頭乳輪温存乳房切除術,センチネルリンパ節生検,右乳腺腫瘍切除術を施行した。病理診断は,左側は広範な非浸潤性乳管癌に5 mmの浸潤性乳管癌(硬性型)を伴うもので,pT1aN0M0,triple negative乳癌であった。右側は異型乳管過形成を伴う乳管内乳頭腫であった。術後は補助化学療法を施行している。末梢性乳管内乳頭腫はしばしば癌を併存,続発するという報告があり,慎重なfollow upが必要である。本症例も右乳房に対しても注意深い観察が必要である。
目次
The patient was a 50-year-old woman. She had been diagnosed with bilateral breast tumors at another hospital 5 years previously and was followed up every 2 months. Ultrasonography showed hypoechoic masses in her breasts. The largest tumor in the right breast was 15 mm in diameter and located in region A, while that in the left breast was 8 mm in diameter and located in region B. Magnetic resonance imaging(MRI)showed multiple bilateral breast tumors. The largest tumor was 12 mm in diameter and was suggestive of breast cancer. Core needle biopsies(CNB)of the largest tumors in both breasts were performed. Intraductal papilloma(IDP)and low-grade intraductal papillary carcinoma were diagnosed in the right and left breasts, respectively, on immunohistochemical staining. We performed left nipple-sparing mastectomy with sentinel lymph node biopsy and right tumor excision for diagnoses of carcinoma of the left breast(cTisN0M0)and IDP of the right breast. The histopathological diagnosis of the left breast tumor was pT1aN0M0, triple negative breast cancer with extensive intraductal components, and that of the right breast tumor was IDP with atypical ductal hyperplasia. Chemotherapy was administered postoperatively. Several studies have reported that peripheral IDP often coexists with or follows the development of carcinoma. Therefore, we should also closely follow-up the patient's right breast.
要旨
症例は50歳,女性。5年前から他院で両側乳房腫瘤を指摘され,2か月ごとのfollowとなっていた。超音波検査では,右側は最大15 mm(A領域),左側は最大8 mm(B領域)の低エコー腫瘤が散発しており,乳房MRIでは両側に最大12 mmの腫瘤を多数認め,乳癌が否定できない所見であった。両側最大径の腫瘤に対し針生検を施行したところ,免疫染色にて右側は乳管内乳頭腫,左側は乳管内乳頭癌と診断された。左乳癌,cTisN0M0,右乳管内乳頭腫の診断で左乳頭乳輪温存乳房切除術,センチネルリンパ節生検,右乳腺腫瘍切除術を施行した。病理診断は,左側は広範な非浸潤性乳管癌に5 mmの浸潤性乳管癌(硬性型)を伴うもので,pT1aN0M0,triple negative乳癌であった。右側は異型乳管過形成を伴う乳管内乳頭腫であった。術後は補助化学療法を施行している。末梢性乳管内乳頭腫はしばしば癌を併存,続発するという報告があり,慎重なfollow upが必要である。本症例も右乳房に対しても注意深い観察が必要である。