乳腺原発の非典型カルチノイドの2例

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  • Two cases of primary atypical carcinoid of the breast
  • ショウレイ ニュウセン ゲンパツ ノ ヒテンケイ カルチノイド ノ 2レイ

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The patient 1, a 46-year-old female who had noticed a lump in her right breast more than one year earlier visited our clinic in May 2010. On physical examination, a 10 × 7.0 cm firm irregular mass in the upper outer quadrant of the right breast and a lymph node 2.0 cm in size in the right axilla were palpable. The tumor was diagnosed as solid-tubular carcinoma by a core needle biopsy. After neoadjuvant chemotherapy (FEC and gemcitabine + paclitaxel), the patient underwent modified radical mastectomy with axillary lymph node dissection in November 2010. The patient 2, a 67-year-old female who had noticed a lump in her right breast about one year earlier visited our clinic in June 2010. On physical examination, a 1.8 × 1.7 cm firm irregular mass in the upper inner quadrant of the right breast was palpable. The tumor was diagnosed as solid-tubular carcinoma by a core needle biopsy. The patient underwent breast conserving surgery and sentinel lymph node biopsy in July 2010. In histopathological examinations of the resected specimens from both cases, the tumor cells proliferated with rosette formation in a solid nest. Grimelius silver stain demonstrated numerous argyrophillic granules in the tumor cells. Immunohistochemically, the tumor cells were positive for chromogranin A, synaptophysin and CEA. Electron microscopy revealed numerous neurosecretory granules. Eventually, the tumor was diagnosed as atypical carcinoid of the breast by the tumor cell pattern and the characteristics of the nuclei. To our knowledge, 33 cases of carcinoid of the breast including our cases have been reported in Japan since 1982. These are the seventh and eighth cases of atypical carcinoid o the breast.

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