高Ca血症クリーゼで骨転移が発見され,術後LH-RH agonist長期投与中の乳癌の1例 A CASE OF BREAST CANCER PRESENTED WITH HYPERCALCEMIC CRISIS WHICH IS ON LONG-TERM ADMINISTRATION OF LH-RH AGONIST

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症例は41歳,女性.6年前の初診時,高Ca血症クリーゼのため緊急入院となり,pamidronateが著効した.左乳癌骨転移による高Ca血症との診断後,LH-RH agonistを含む内分泌・化学療法が奏効し,入院45日目にAuchincloss法を施行した. t2n1 βm Stage IVで組織学的には硬癌であった. ER・PgRともに陰性であったが,術後LH-RH agonist, ADM, 5'-DFUR, MPAの併用で寛解を得た.術後42カ月目に骨転移が再燃したが,化学・放射線(Co)療法で再び寛解が得られた. LH-RH agonistを継続し,維持療法を行っていたが,術後66カ月目に胸骨柄部に腫瘤形成して再々燃してきた.化学療法は奏効せず, Liniac (X線4MeV)照射したところ,寛解が得られた. 6年以上にわたりLH-RH agonistを使用しているが,その間,月経の発来,骨塩量減少もなく,骨以外に新たな転移巣を認めずに経過している.

We report a case of breast cancer presented with hypercalcemic crisis which is on long-term administration of LH-RH agonist. Six years before when the patient (premenopausal woman) was 35 years old, she was admitted to the hospital because of hypercalcemia and was successfully treated by pamidronate. After making diagnosis of hypercalcemia due to multiple bone metastases of left breast concer, chemo-endocrine therapy including LH-RH agonist was started, with good outcome. So an atypical mastectomy was performed on the 45th hospital day. Although both ER and PgR were negative, combinative administration of LH-RH agonist, ADM, 5'-DFUR and MPA provided a partial response. A bone scincigram revealed re-accumulations 42 months postoperatively, but with chemotherapy and irradiation (Co), a partial response was attained agein. Continuous administration of LH-RH agonist, UFT and FAD was kept while she was followed in the outpatient clinic. A painful mass arisen in the sternal manubrium developed 66 months postoperatively. Liniac irradiation (X-ray, 4MeV) was effective for the tumor. The patient is doing fair by taking LH-RH agonist for over 75 months.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 63(5), 1112-1116, 2002-05-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008912871
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
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