腹膜播種を伴った乳腺浸潤性小葉癌の1例  [in Japanese] INVASIVE LOBULAR CARCINOMA OF THE BREAST WITH PERITONITIS CARCINOMATOSA : A CASE OF REPORT  [in Japanese]

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Abstract

症例は45歳の女性.腹部膨満感を主訴に当院を受診.卵巣癌・腹水貯留の診断にて2000年6月1日に産婦人科で手術を施行し,後腹膜の広範囲な線維化を認めた.右乳腺腫瘍も伴っていたため,外科転科の上で6月14日に右乳房切除術と開腹生検術を施行した.病理組織学的には,乳腺浸潤性小葉癌からの腹膜播種と診断された.術後にCEF療法(CPA, EPI, 5-FU)とMPA投与を行ったところ腹水が消失したため,退院.以後は外来で同療法を継続している.開始後約1年6カ月経過し,再燃は認めていない.<br> 浸潤性小葉癌は,本邦では比較的稀な疾患である.特異的な転移形式として腹膜播種や後腹膜転移,卵巣転移をきたすことがある.本症例のように特異な経過をたどることがあるため,注意を払う必要がある.

A 45-year-old woman admitted to the gynecologic department in our hospital underwent surgical intervention for ovarian cancer with retention of ascites. During the operation, the gynecologists confirmed widespread retroperitoneal fibrosis, and referred her to our surgical clinic. Further examinations disclosed right breast cancer. A right mastectomy and a laparotomic biopsy were thus performed. Histologic examination of the removed breast tumor revealed invasive lobular carcinoma with partly signet ring cells. The definite diagnosis of peritonitis carcinomatosa resulting from metastasis of the breast cancer was made. After the operation, CEF therapy (CPA, EPI, 5-FU) and administration of MPA were started. Ascites disappeared almost completely. Thereafter the patient maintained on the regime in the outpatient clinic. No signs of recurrence were noted at an 18-month follow-up study after the chemotherapy. Although invasive lobular carcinoma is a relatively rare entity, it is important to know that the carcinoma can metastasize in an unusual pattern showing peritonitis carcinomatosa, retroperitoneal infiltation, and ovarian metastasis like in this case.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(6), 1362-1365, 2002-06-25

    Japan Surgical Association

References:  15

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008913626
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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