術後3年目に対側乳房再発を認めた乳腺血管肉腫の1例 A CASE OF ANGIOSARCOMA OF THE BREAST METASTASIZED TO THE CONTRALATERAL BREAST 3 YEARS AFTER SURGERY

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右乳腺血管肉腫に対して手術を行った後,約3年を経て対側乳房内再発を認めた1例を経験したので報告する.症例は40歳女性,全経過を通じて放射線の被曝歴はない.約3年前に右乳腺血管肉腫に対して単純乳房切除施行後,外来にて経過観察されていたが,平成15年4月左乳房C領域に径3 cmの腫瘤を自覚し来院した. 7月17日腫瘤摘出術を行うも病理診断にて断端陽性であったため, 8月5日左単純乳房切除を施行した.病理組織学的には,浸潤性に増殖する血管肉腫であり, intermediate gradeと診断された.術前後の各種画像診断では他臓器転移は認めなかった.乳房血管肉腫は,良性の血管腫との鑑別診断および悪性度の判定が困難であり,手術以外の治療手段がほとんど無効であることから予後不良の疾患とされている.今後,乳房温存療法の普及に伴う放射線照治療の増加により,本疾患の増加が予想される.

This paper deals with a 40-year-old woman who experienced metastasis to the contralateral breast about 3 years after surgery for angiosarcoma of the right breast. The patent had not been exposed to radiation through the entire clinical course. After undergoing simple mastectomy for angiosarcoma of the right breast about 3 years earlier, she had been followed in the clinic. In April 2003, she was seen at the hospital because she felt a tumor about 3 cm in diameter in the C area of the left breast. On July 17, the tumor was removed, when the surgical stump was found to be positive. Then left simple mastectomy was carried out on August 5. Histopathologically the tumor was diagnosed as invasively growing angiosarcoma, intermediate grade. On pre-and post-operative imaging methods, no metastasis to the other organs was revealed.<br>We have great difficulties in differentiation of breast angiosarcoma from benign angiomas and in the assessment of the degree of malignancy, and almost all therapies are ineffective except for surgery. The disease is accordingly thought to have poor prognosis. Future increase of the disease is predicted with further increase in radiation therapy along with the spread of breast-conservative therapy.

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 65(8), 2090-2094, 2004-08-25

    日本臨床外科学会

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各種コード

  • NII論文ID(NAID)
    10013670709
  • 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  CJP引用  J-STAGE 
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