HER-2陽性であった乳腺 adenomyoepithelioma の1例 A CASE OF ADENOMYOEPITHELIOMA OF THE BREAST
乳腺腺筋上皮腫(adenomyoepithelioma: AME)は稀な疾患で,一般的には良性とされる.今回,胸部CTで偶然発見されたAMEを経験した.症例は85歳,女性.右乳房A領域の17mm大の腫瘤で,マンモグラフィ上高濃度な分葉状腫瘤影で,乳腺超音波検査では内部均一低エコーを示し悪性を疑った.約2cmのマージンをとった乳房部分切除を行い,術中病理でAMEと診断された.組織学的には腺管とその周囲の筋上皮細胞の増生からなる腫瘍で, S-100蛋白(+), α-SMA (+)でAMEと確定され, ER(+), PgR(+), HER-2(2+)であった. AMEは局所再発や稀に肺・脳などの遠隔転移も報告され,定期的な経過観察が必要である.
Adenomyoepithelioma (AME) of the breast is generally a benign lesion and occurs rarely. Herein we report a case of AME which was accidentally detected by a chest CT scan.<br> An 85-year-old woman received a routine follow-up chest CT examination after the surgery for a thoracic aortic aneurysm, when a 17-mm sized nodular lesion was accidentally found at the uppermedian region of her right breast. Mammography showed an oval high-density tumor and ultrasonography showed a 1.2×1.4cm hypoechoic and homogeneous tumor. Breast cancer was suspected and a partial mastectomy with surgical margin of about 2cm was performed. Intraoperative pathology demonstrated hyperplasia of the mammary ducts and periductal myoepithelial cells. Since the myoepithelial cells were positive for S-100 and partially positive for α-SMA, the pathological diagnosis was made as AME. Furthermore ER and PgR were both positive, and HER-2 was evaluated as 2+. Since it has beer reported that local recurrence and metastasis to the lung or brain of AME occurred in some cases periodical follow-up studies are necessary for the patient.
- 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 66(9), 2103-2106, 2005-09-25
Japan Surgical Association