内容紹介
Summary
A 46-year-old woman visited our hospital with the chief complaint of left axillary mass enlargement, which she had been aware of for 8 years. Palpation revealed that the mass was 15 mm in size. Redness and gathering of the skin were also observed. Mammographic imaging of the left axilla revealed an irregular mass with skin infiltration. Breast ultrasonography revealed a low echo mass in the left axilla, which was continuous from the skin. Core needle biopsy was used to diagnose the tumor as an invasive ductal carcinoma. No other lesions were observed in the breast, and primary lesions were not found in any other organs. The patient was diagnosed with axillary accessory breast cancer and underwent local extensive resection and axillary lymph node dissection. Because the skin defect was widespread, we performed axillary reconstruction using the latissimus dorsi musculocutaneous flap to prevent upper limb contracture. At present, she can move her upper limbs and lymphedema has not been observed. In cases of axillary accessory breast cancer with skin infiltration, reconstruction using the latissimus dorsi musculocutaneous flap can be a useful procedure.
要旨
症例は46歳,女性。8年前より自覚していた左腋窩腫瘤の増大を主訴に当院を受診した。左腋窩に皮膚の発赤と引きつれを伴う約15 mmの硬結を触知し,マンモグラフィ左腋窩撮像で皮膚に浸潤する不整形腫瘤を認めた。乳腺超音波検査では,左腋窩に皮膚より連続する約17 mmの不整形腫瘤を認めた。同部位より針生検を行い,invasive ductal carcinomaの診断となった。乳房内に病変を認めず,PET-CTで他臓器に転移や腫瘍性病変はなく左腋窩副乳癌と診断し,左腋窩局所広範囲切除術・腋窩リンパ節郭清を施行した。皮膚浸潤を伴っていたため皮膚欠損が広範囲に及ぶと判断し,拘縮による上肢挙上制限予防のために広背筋皮弁による腋窩再建を施行した。術後経過は良好で患側上肢の可動性は確保され,リンパ浮腫なども認めていない。皮膚浸潤を伴う腋窩副乳癌において,局所広範囲切除術・腋窩リンパ節郭清に加えて広背筋皮弁による再建を行うことは有用な術式であると考えられた。
目次
A 46-year-old woman visited our hospital with the chief complaint of left axillary mass enlargement, which she had been aware of for 8 years. Palpation revealed that the mass was 15 mm in size. Redness and gathering of the skin were also observed. Mammographic imaging of the left axilla revealed an irregular mass with skin infiltration. Breast ultrasonography revealed a low echo mass in the left axilla, which was continuous from the skin. Core needle biopsy was used to diagnose the tumor as an invasive ductal carcinoma. No other lesions were observed in the breast, and primary lesions were not found in any other organs. The patient was diagnosed with axillary accessory breast cancer and underwent local extensive resection and axillary lymph node dissection. Because the skin defect was widespread, we performed axillary reconstruction using the latissimus dorsi musculocutaneous flap to prevent upper limb contracture. At present, she can move her upper limbs and lymphedema has not been observed. In cases of axillary accessory breast cancer with skin infiltration, reconstruction using the latissimus dorsi musculocutaneous flap can be a useful procedure.
要旨
症例は46歳,女性。8年前より自覚していた左腋窩腫瘤の増大を主訴に当院を受診した。左腋窩に皮膚の発赤と引きつれを伴う約15 mmの硬結を触知し,マンモグラフィ左腋窩撮像で皮膚に浸潤する不整形腫瘤を認めた。乳腺超音波検査では,左腋窩に皮膚より連続する約17 mmの不整形腫瘤を認めた。同部位より針生検を行い,invasive ductal carcinomaの診断となった。乳房内に病変を認めず,PET-CTで他臓器に転移や腫瘍性病変はなく左腋窩副乳癌と診断し,左腋窩局所広範囲切除術・腋窩リンパ節郭清を施行した。皮膚浸潤を伴っていたため皮膚欠損が広範囲に及ぶと判断し,拘縮による上肢挙上制限予防のために広背筋皮弁による腋窩再建を施行した。術後経過は良好で患側上肢の可動性は確保され,リンパ浮腫なども認めていない。皮膚浸潤を伴う腋窩副乳癌において,局所広範囲切除術・腋窩リンパ節郭清に加えて広背筋皮弁による再建を行うことは有用な術式であると考えられた。