内容紹介
Summary
Recently, with the increase in the number of young cancer patients, we often encounter multiple primary cancer(MPC). In MPC, careful examination is necessary because the treatment order and policies change greatly depending on the stage and prognosis of each tumor. We report a case of synchronous MPC of endometrial cancer and breast cancer. The patient was a 40-year-old woman who underwent endometrial cytology by a previous doctor due to illicit bleeding. As a result of the diagnosis of classⅢB, she underwent gynecological examination in our hospital. Endometroid adenocarcinoma Grade 2 was diagnosed based on endoscopic findings. On pelvic MRI, a lesion adjacent to the neck showed a low signal in the uterine body compared to that in the endocardium. During the preoperative examination, CT showed contrast nodules in the right breast, and ultrasonography was performed at the department of breast surgery. Ultrasonography showed a low-echo mass of 23 mm in the right upper midline region. The needle biopsy results were papillotubular cancer(ER-negative, PgR-negative, HER2 1+, Ki-67 77%). Based on these findings, right breast cancer and endometrial cancer were diagnosed. Initially, we performed right mastectomy and sentinel lymph node biopsy; we then performed pancreatectomy in the gynecology department 2 weeks after discharge. After surgery, gynecology studied 6 courses of TC therapy, and currently, EC is undergoing breast surgery.
要旨
昨今,癌罹患者数の増加と生存率の上昇に伴い,重複癌を経験することは少なくない。特に同時性重複癌は,各腫瘍の病期・予後により治療の順番や方針が大きく変化するため慎重な検討が必要となる。今回,乳癌・子宮体癌の同時性重複癌を経験したため報告する。症例は40歳,女性。不正出血のため当院婦人科を受診し,組織診でendometroid adenocarcinoma Grade 2の診断となった。骨盤部MRI検査では子宮体部に,頸部に隣接した病変を認めた。術前検査を施行中,造影CTで右乳房に造影結節を認め精査目的に乳腺外科受診となった。 超音波検査で右AC領域に23 mm大の分葉状低エコー腫瘤を認めた。針生検の結果はpapillotubular carcinoma(ER陰性,PgR陰性,HER2 1+,Ki-67 77%)であった。以上より,右乳癌,T2N0M0,stageⅡB,子宮体癌,T2N0M0,stageⅡの診断となり,乳腺外科で右Bt+SNを施行し,退院2週間後に婦人科で広汎子宮全摘術を施行した。術後は婦人科でTC療法を6コース実施し,現在は乳腺外科でEC療法を施行中である。
目次
Recently, with the increase in the number of young cancer patients, we often encounter multiple primary cancer(MPC). In MPC, careful examination is necessary because the treatment order and policies change greatly depending on the stage and prognosis of each tumor. We report a case of synchronous MPC of endometrial cancer and breast cancer. The patient was a 40-year-old woman who underwent endometrial cytology by a previous doctor due to illicit bleeding. As a result of the diagnosis of classⅢB, she underwent gynecological examination in our hospital. Endometroid adenocarcinoma Grade 2 was diagnosed based on endoscopic findings. On pelvic MRI, a lesion adjacent to the neck showed a low signal in the uterine body compared to that in the endocardium. During the preoperative examination, CT showed contrast nodules in the right breast, and ultrasonography was performed at the department of breast surgery. Ultrasonography showed a low-echo mass of 23 mm in the right upper midline region. The needle biopsy results were papillotubular cancer(ER-negative, PgR-negative, HER2 1+, Ki-67 77%). Based on these findings, right breast cancer and endometrial cancer were diagnosed. Initially, we performed right mastectomy and sentinel lymph node biopsy; we then performed pancreatectomy in the gynecology department 2 weeks after discharge. After surgery, gynecology studied 6 courses of TC therapy, and currently, EC is undergoing breast surgery.
要旨
昨今,癌罹患者数の増加と生存率の上昇に伴い,重複癌を経験することは少なくない。特に同時性重複癌は,各腫瘍の病期・予後により治療の順番や方針が大きく変化するため慎重な検討が必要となる。今回,乳癌・子宮体癌の同時性重複癌を経験したため報告する。症例は40歳,女性。不正出血のため当院婦人科を受診し,組織診でendometroid adenocarcinoma Grade 2の診断となった。骨盤部MRI検査では子宮体部に,頸部に隣接した病変を認めた。術前検査を施行中,造影CTで右乳房に造影結節を認め精査目的に乳腺外科受診となった。 超音波検査で右AC領域に23 mm大の分葉状低エコー腫瘤を認めた。針生検の結果はpapillotubular carcinoma(ER陰性,PgR陰性,HER2 1+,Ki-67 77%)であった。以上より,右乳癌,T2N0M0,stageⅡB,子宮体癌,T2N0M0,stageⅡの診断となり,乳腺外科で右Bt+SNを施行し,退院2週間後に婦人科で広汎子宮全摘術を施行した。術後は婦人科でTC療法を6コース実施し,現在は乳腺外科でEC療法を施行中である。