内容紹介
Summary
The first case is a 62-year-old female who complained of painful left axillary lymph node swelling. Six months later, a CT scan revealed multiple lung nodules. Biopsies of the axillary lymph node and lung showed metastatic carcinoma from breast cancer. However, no breast tumor was found. She was diagnosed with occult breast cancer with metastasis to the axillary lymph node and lung. ER(+), PgR(±), HER2(1+). Letrozole was administered, and effective control was achieved for 20 months. The second case is a 62-year-old female who presented with back pain. A CT scan revealed left axillary lymph node swelling and multiple osteolytic changes in the thoracolumbar spine and rib. Biopsies of the axillary lymph node and thoracic spine showed metastatic carcinoma from breast cancer. However, no breast tumor was found. She was diagnosed with occult breast cancer with metastasis to the axillary lymph nodule and bone. ER(+), PgR(+), HER2(1+). Fulvestrant and denosumab were administered. However, after 6 months, she discontinued the treatment. Our results suggested that effective control could be achieved through systemic therapy and local therapy was not necessary for StageⅣ occult breast cancer.
要旨
症例1は62歳,女性。有痛性の左腋窩リンパ節腫脹を自覚し,当院を受診した。炎症性腫瘤と考え抗生剤加療を行ったが,6か月後多発肺結節影が明瞭化し,転移性肺腫瘍を疑った。生検で乳癌由来が疑われたが乳腺に異常所見を認めず,StageⅣ潜在性乳癌と診断した。letrozoleを開始し,20か月健在である。症例2は62歳,女性。背部痛を自覚し,当院を受診した。CT検査で多発溶骨性変化と左腋窩リンパ節腫脹を認めた。両者の生検で乳癌由来が疑われたが乳腺に異常所見を認めず,StageⅣ潜在性乳癌と診断した。fulvestrant,denosumabを開始したが,6か月後本人の希望により治療を中止している。StageⅣ潜在性乳癌の治療方針について文献的考察を加えて報告する。
目次
The first case is a 62-year-old female who complained of painful left axillary lymph node swelling. Six months later, a CT scan revealed multiple lung nodules. Biopsies of the axillary lymph node and lung showed metastatic carcinoma from breast cancer. However, no breast tumor was found. She was diagnosed with occult breast cancer with metastasis to the axillary lymph node and lung. ER(+), PgR(±), HER2(1+). Letrozole was administered, and effective control was achieved for 20 months. The second case is a 62-year-old female who presented with back pain. A CT scan revealed left axillary lymph node swelling and multiple osteolytic changes in the thoracolumbar spine and rib. Biopsies of the axillary lymph node and thoracic spine showed metastatic carcinoma from breast cancer. However, no breast tumor was found. She was diagnosed with occult breast cancer with metastasis to the axillary lymph nodule and bone. ER(+), PgR(+), HER2(1+). Fulvestrant and denosumab were administered. However, after 6 months, she discontinued the treatment. Our results suggested that effective control could be achieved through systemic therapy and local therapy was not necessary for StageⅣ occult breast cancer.
要旨
症例1は62歳,女性。有痛性の左腋窩リンパ節腫脹を自覚し,当院を受診した。炎症性腫瘤と考え抗生剤加療を行ったが,6か月後多発肺結節影が明瞭化し,転移性肺腫瘍を疑った。生検で乳癌由来が疑われたが乳腺に異常所見を認めず,StageⅣ潜在性乳癌と診断した。letrozoleを開始し,20か月健在である。症例2は62歳,女性。背部痛を自覚し,当院を受診した。CT検査で多発溶骨性変化と左腋窩リンパ節腫脹を認めた。両者の生検で乳癌由来が疑われたが乳腺に異常所見を認めず,StageⅣ潜在性乳癌と診断した。fulvestrant,denosumabを開始したが,6か月後本人の希望により治療を中止している。StageⅣ潜在性乳癌の治療方針について文献的考察を加えて報告する。