内容紹介
Summary
An 83-year-old woman visited our hospital with a mass on her right breast mass. Breast ultrasonography revealed a tumorous lesion approximately 30 mm in diameter in the right E region. Fibrous tumor was suspected from core needle biopsy. Since surgery for definite diagnosis was not desired, she was followed. Seven months after the first visit, skin redness, pain, and rapid increase in tumor size was consciously recognized, which prompted a reconsultation. The tumor diameter rapidly increased to 74 mm, and a total right mastectomy was performed as a semi-emergency procedure. Necrotic and hemorrhagic lesions were mixed in a mottled state in the cleaved surface of the excised specimen, and the pathological diagnosis was stromal sarcoma mainly comprising of fibrosarcoma components. Stromal sarcoma of the breast lacks the epithelial component of a malignant phyllodes tumor, and effective systemic therapy has not been established; therefore, cases with local recurrence or distant metastasis result in poor prognosis. Since we encountered a case of stromal sarcoma of the breast that showed a rapid increase after several months, we will provide a report with some literature consideration.
要旨
症例は83歳,女性。右乳房E領域に径30 mmほどの腫瘤性病変を認め針生検の結果から線維性腫瘍が疑われた。確定診断の手術は希望されず経過観察の方針となった。初診より7か月後に皮膚発赤,疼痛と腫瘤の急速増大を自覚し再受診となった。腫瘍は径74 mmと急速に増大しており準緊急で右胸筋温存乳房全切除術を行った。摘出検体の割面は壊死巣と出血巣がまだら状に混在しており,病理結果は線維肉腫成分主体の間質肉腫の診断であった。術後12か月現在,微小な肺結節を認めるが生存中である。急速増大を示す乳腺間質肉腫の報告例は散見され予後不良の可能性が指摘されているが,腫瘍からの出血が径に影響する可能性があるため,急速な変化が予後に必ずしも関連するとはいい難いのではないかと思いここに報告した。
目次
An 83-year-old woman visited our hospital with a mass on her right breast mass. Breast ultrasonography revealed a tumorous lesion approximately 30 mm in diameter in the right E region. Fibrous tumor was suspected from core needle biopsy. Since surgery for definite diagnosis was not desired, she was followed. Seven months after the first visit, skin redness, pain, and rapid increase in tumor size was consciously recognized, which prompted a reconsultation. The tumor diameter rapidly increased to 74 mm, and a total right mastectomy was performed as a semi-emergency procedure. Necrotic and hemorrhagic lesions were mixed in a mottled state in the cleaved surface of the excised specimen, and the pathological diagnosis was stromal sarcoma mainly comprising of fibrosarcoma components. Stromal sarcoma of the breast lacks the epithelial component of a malignant phyllodes tumor, and effective systemic therapy has not been established; therefore, cases with local recurrence or distant metastasis result in poor prognosis. Since we encountered a case of stromal sarcoma of the breast that showed a rapid increase after several months, we will provide a report with some literature consideration.
要旨
症例は83歳,女性。右乳房E領域に径30 mmほどの腫瘤性病変を認め針生検の結果から線維性腫瘍が疑われた。確定診断の手術は希望されず経過観察の方針となった。初診より7か月後に皮膚発赤,疼痛と腫瘤の急速増大を自覚し再受診となった。腫瘍は径74 mmと急速に増大しており準緊急で右胸筋温存乳房全切除術を行った。摘出検体の割面は壊死巣と出血巣がまだら状に混在しており,病理結果は線維肉腫成分主体の間質肉腫の診断であった。術後12か月現在,微小な肺結節を認めるが生存中である。急速増大を示す乳腺間質肉腫の報告例は散見され予後不良の可能性が指摘されているが,腫瘍からの出血が径に影響する可能性があるため,急速な変化が予後に必ずしも関連するとはいい難いのではないかと思いここに報告した。