乳房温存術後の放射線療法終了直後に皮膚筋炎を発症した早期乳癌の１例

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  • A CASE OF EARLY BREAST CANCER WITH THE DEVELOPMENT OF DERMATOMYOSITIS IMMEDIATELY AFTER RADIOTHERAPY FOLLOWING BREAST-CONSERVING SURGERY

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The authors encountered a case of early breast cancer with the development of dermatomyositis immediately after radiotherapy that followed breast-conserving surgery. The patient, a 52-year-old female, was diagnosed with cancer of the breast and underwent breast-conserving surgery and sentinel lymph node biopsy in May, 2004. The pathological diagnosis was solid tubular carcinoma T1N0M0, stage I, ER(+), PgR(-). Hormone (Toremifene) administration was initiated from June, and radiotherapy was applied to the remaining breast starting in July. Immediately after the treatment was completed (August), the patient suddenly developed general fatigue, skin eruption and deglutition difficulty, and edema extending from her face to the neck. She was then re-etamined in our department at the end of August. Because hepatic dysfunction was noted, drug-induced hepatitis was suspected, and hormone therapy was interrupted. However, there was no improvement in the symptoms, and the blood creatine kinase level rose without any obvious reasons together with a simultaneous loss of muscular strength of the upper and lower extremities. In September, she was admitted to the hospital, where, following detailed tests, a diagnosis of dermatomyositis was made. It was presumed that stresses, such as surgery and radiotherapy, were responsible for the development of this disease. It is well-known that dermatomyositis is frequently associated with malignant tumors. The current case is introduced because it is rare that the former is preceded by the latter.

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