Sato Tomoi, Muto Ichiro, Hasegawa Masaki, Aono Takashi, Okada Takayuki, Tamura Tetsuro, Sakai Takeshi
Department of Surgery, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan.
Breast Cancer. 2007;14(3):302-6. doi: 10.2325/jbcs.14.302.
We report here a rare form of invasive ductal carcinoma composed of a mass protruding from the tip of the nipple in a 43-year-old woman with hyperprolactinemia. She had been amenorrheic for 15 years following an incomplete pituitary adenomectomy for prolactinoma. She presented with a mass on the left nipple that had been growing for 6 months. Morphologically, the mass resembled adenoma of the nipple. Another mass was located in the subareolar region. She underwent mastectomy after invasive ductal carcinoma was diagnosed. Histopathologically, the tumor of the nipple was invasive ductal carcinoma, which had extended intraductally from another invasive ductal carcinoma in the subareolar region, and had infiltrated the epidermis of the nipple (Paget's disease). MR mammography successfully detected the relationship between the tumors. Postoperatively, the plasma prolactin level was abnormally high, while the plasma estradiol level was quite low, although macro-pituitary adenoma was not detected by MRI. The patient was treated with bromocriptine mesilate, in addition to adjuvant chemotherapy for breast cancer, and the plasma prolactin level has since normalized.
我们在此报告一例罕见的浸润性导管癌，发生于一名43岁高催乳素血症女性，表现为乳头尖端突出的肿块。她因泌乳素瘤接受垂体腺瘤不完全切除术后闭经15年。她因左侧乳头肿物生长6个月就诊。形态学上，该肿物类似乳头腺瘤。另一个肿物位于乳晕下区域。诊断为浸润性导管癌后，她接受了乳房切除术。组织病理学检查显示，乳头肿瘤为浸润性导管癌，起源于乳晕下区域的另一个浸润性导管癌，并已侵犯乳头表皮（派杰病）。乳腺磁共振成像成功检测到了肿瘤之间的关系。术后，血浆催乳素水平异常升高，而血浆雌二醇水平相当低，尽管MRI未检测到垂体大腺瘤。该患者除接受乳腺癌辅助化疗外，还接受了甲磺酸溴隐亭治疗，此后血浆催乳素水平已恢复正常。
