乳癌骨髄癌症の１例

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  • A CASE OF BONE MARROW CARCINOMATOSIS OF BREAST CANCER

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This paper deals with a 55-year-old woman with bone marrow carcinomatosis of breast cancer. The patient had undergone a partial mastectomy for left breast cancer in June 1999, which was located in the left D area, was 15×15mm in diameter, invasive ductal carcinoma, scirrous type, f, tl, T1NXM1 stage IV, and both ER and PgR positive. Cancerous pleuritis and multiple bone metastases were found and systemic hormone therapy with toremifene and chemotherapy with cyclophosphamide, methotrexate, and 5-FU (VMF) were conducted. In October 2001, she was admitted to the hospital because of acute hemolytic anemia. Bone marrow examination to explore the cause revealed metastasis of adenocarcinoma. We thus diagnosed the case as microangiopathic hemolytic anemia (MHA) caused by bone marrow carcinomatosis of breast cancer. After hemolytic anemia improved by symptomatic treatment, docetaxel therapy was started carefully. Docetaxel therapy continued effectively for 10 times without recurrence of MHA or DIC on an ambulant basis. Finally she died of liver failure due to liver metastasis 45 months after the operation. In general bone marrow carcinomatosis is often associated with DIC and rapidly progresses to its termination, however, this patient could survive for a long time maintaining good QOL by effective systemic chemotherapy.

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