Matsuo K, Fukutomi T, Tsuda H, Hasegawa T, Akashi-Tanaka S, Nanasawa T
Department of Surgical Oncology, National Cancer Center Hospital, 1-1, Tsukiji, 5-chome, Chuo-ku, Tokyo 104-0045, Japan.
Breast Cancer. 2001;8(1):79-83. doi: 10.1007/BF02967483.
A 64-year postmenopausal woman had noticed a left breast lump 5 months before presentation and was admitted due to increasing tumor size. Physical examination showed a well demarcated, movable mass 5 cm in diameter in the upper outer quadrant of the left breast. The lesion was not painful. She had no past history of malignancy or chest wall irradiation. She had no family history of malignancy. Mammography revealed an irregular tumorous lesion with coarse calcifications in the left breast. Intracystic papillary cancer was suspected by ultrasonography. Aspiration breast cytology yielded insufficient material for diagnosis. Laboratory findings were all within the normal limits including alkaline phosphatase and three tumor markers (CEA, CA 15-3, ST-439). An excisional biopsy of the left breast tumor was performed. Histopathological examination revealed malignant phyllodes tumor with osteosarcomatous features and negative tumor margins. Positive vimentin and negative cytokeratin staining was confirmed by immunohistochemistry, suggesting that the tumor did not originate from epithelial cells of the breast. The estrogen receptor (ER) status of the tumor was negative but progesterone receptor (PgR) was weakly positive. Positive p53 nuclear immunoreaction but negative c-erbB-2 overexpression by immunohistochemical staining was observed in this tumor. There was no evidence of generalized disease. She has been well 6 months after surgery without adjuvant therapy.
一位64岁的绝经后女性在就诊前5个月发现左乳肿块，因肿瘤增大而入院。体格检查显示左乳外上象限有一个边界清晰、可移动的肿块，直径5厘米。该病变无疼痛。她既往无恶性肿瘤病史或胸壁放疗史。她无恶性肿瘤家族史。乳腺X线摄影显示左乳有一个不规则的肿瘤性病变，伴有粗大钙化。超声检查怀疑为囊内乳头状癌。乳腺穿刺细胞学检查获取的诊断材料不足。实验室检查结果均在正常范围内，包括碱性磷酸酶和三种肿瘤标志物（癌胚抗原、CA 15-3、ST-439）。对左乳肿瘤进行了切除活检。组织病理学检查显示为具有骨肉瘤特征的恶性叶状肿瘤，切缘阴性。免疫组织化学证实波形蛋白阳性、细胞角蛋白阴性，提示肿瘤并非起源于乳腺上皮细胞。肿瘤的雌激素受体（ER）状态为阴性，但孕激素受体（PgR）弱阳性。免疫组织化学染色显示该肿瘤p53核免疫反应阳性，但c-erbB-2无过表达。无全身疾病证据。术后6个月，未接受辅助治疗，她情况良好。
