内容紹介
Summary
Primary small cell carcinoma in the breast is a rare and aggressive tumor, and a standard treatment strategy has not been established. Herein, we report a 35-year-old woman with primary small cell carcinoma in the breast. She had an 8 cm diameter tumor in the right breast. She was diagnosed with small cell carcinoma(cT3N1M0, cStage ⅢA)in the right breast, and neoadjuvant chemotherapy was planned. She received a combination chemotherapy of cisplatin(CDDP)and etoposide(VP-16)based on the regimen for pulmonary small cell carcinoma; however, the disease showed progression. Therefore, 5-FU plus epirubicin plus cyclophosphamide(FEC)and weekly paclitaxel(PTX)chemotherapy based on a regimen for breast cancer were administered, and the tumor was partially reduced in size. Modified radical mastectomy followed by radiotherapy and hormonal therapy was performed. Ten months after the surgery, multiple liver and bone metastases occurred, and the patient died the following month. Further studies in other such patients are needed.
要旨
乳腺原発小細胞癌はまれで進行が早く,明確な治療方針が存在しない。今回,術前化学療法に難渋した乳腺原発小細胞癌の症例を経験したので報告する。症例は35歳,女性。右乳房腫瘤を主訴に受診し,8 cm大の腫瘤を認めた。精査で乳腺原発小細胞癌,cT3N1M0,cStage ⅢA,ER陽性HER2陰性と診断した。術前化学療法の方針とし,肺小細胞癌に準じてcisplatin(CDDP)+etoposide(VP-16)を施行したが,腫瘍は増大した。次に乳癌に準じてFEC療法(5-FU+epirubicin+cyclophosphamide),続いてweekly paclitaxel(PTX)を施行し,腫瘍は縮小した。乳房切除術および腋窩リンパ節郭清を施行した。術後放射線療法,ホルモン療法を施行したが,10か月後に多発肝転移,骨転移で再発し,術後11か月に死亡した。治療方針を確立するため,症例の蓄積が望まれる。
目次
Primary small cell carcinoma in the breast is a rare and aggressive tumor, and a standard treatment strategy has not been established. Herein, we report a 35-year-old woman with primary small cell carcinoma in the breast. She had an 8 cm diameter tumor in the right breast. She was diagnosed with small cell carcinoma(cT3N1M0, cStage ⅢA)in the right breast, and neoadjuvant chemotherapy was planned. She received a combination chemotherapy of cisplatin(CDDP)and etoposide(VP-16)based on the regimen for pulmonary small cell carcinoma; however, the disease showed progression. Therefore, 5-FU plus epirubicin plus cyclophosphamide(FEC)and weekly paclitaxel(PTX)chemotherapy based on a regimen for breast cancer were administered, and the tumor was partially reduced in size. Modified radical mastectomy followed by radiotherapy and hormonal therapy was performed. Ten months after the surgery, multiple liver and bone metastases occurred, and the patient died the following month. Further studies in other such patients are needed.
要旨
乳腺原発小細胞癌はまれで進行が早く,明確な治療方針が存在しない。今回,術前化学療法に難渋した乳腺原発小細胞癌の症例を経験したので報告する。症例は35歳,女性。右乳房腫瘤を主訴に受診し,8 cm大の腫瘤を認めた。精査で乳腺原発小細胞癌,cT3N1M0,cStage ⅢA,ER陽性HER2陰性と診断した。術前化学療法の方針とし,肺小細胞癌に準じてcisplatin(CDDP)+etoposide(VP-16)を施行したが,腫瘍は増大した。次に乳癌に準じてFEC療法(5-FU+epirubicin+cyclophosphamide),続いてweekly paclitaxel(PTX)を施行し,腫瘍は縮小した。乳房切除術および腋窩リンパ節郭清を施行した。術後放射線療法,ホルモン療法を施行したが,10か月後に多発肝転移,骨転移で再発し,術後11か月に死亡した。治療方針を確立するため,症例の蓄積が望まれる。