Gu Guo-Li, Wang Shi-Lin, Wei Xue-Ming, Ren Li, Zou Fu-Xian
Department of General Surgery, the General Hospital of Chinese PLA Air force, Beijing City, 100142, PR China.
Cases J. 2008 Oct 30;1(1):285. doi: 10.1186/1757-1626-1-285.
Breast cancer is very rare in men, and the occurrence of occult breast cancer which present axillary metastasis as the first manifestation is even rarer in men.
We report a 72-year-old male Han-Chinese patient who presented axillary metastasis as the first manifestation of breast cancer and got correctly diagnoses by histological examination. He underwent modified radical mastectomy and axillary dissection on 11 Apr 2006. The histopathologic examination showed that no tumor focus was found in his breast tissue, but two out of fifteen of axillary lymph nodes were invaded by infiltrating ductal carcinoma. The IHC stain showed that estrogen receptor (ER) and progestin receptor (PR) were negative, Human epidermal receptor (HER-2) oncoprotein (+++), P53 protein expressed (+++), Bcl-2 oncoprotein (+++), nm23 protein (++), proliferating cell nuclear antigen (PCNA) (+++) and multidrug-resistance protein (MRP) (++). After operation, he did not receive endocrine therapy, chemotherapy and radiotherapy because of his senility. He is alive without any residual or metastasis disease 29 months after being diagnosed.
This is the first case in our hospital that presents axillary metastases as the first manifestation of male breast cancer.
男性乳腺癌非常罕见，而以腋窝转移为首发表现的隐匿性乳腺癌在男性中更为罕见。
我们报告一名72岁汉族男性患者，其以腋窝转移为乳腺癌的首发表现，并通过组织学检查得以正确诊断。他于2006年4月11日接受了改良根治性乳房切除术及腋窝淋巴结清扫术。组织病理学检查显示其乳腺组织未发现肿瘤病灶，但15枚腋窝淋巴结中有2枚被浸润性导管癌侵犯。免疫组化染色显示雌激素受体（ER）和孕激素受体（PR）均为阴性，人表皮受体（HER-2）癌蛋白（+++），P53蛋白表达（+++），Bcl-2癌蛋白（+++），nm23蛋白（++），增殖细胞核抗原（PCNA）（+++）以及多药耐药蛋白（MRP）（++）。术后，由于其高龄，未接受内分泌治疗、化疗及放疗。确诊29个月后，他仍存活，无任何残留或转移病灶。
这是我院首例以腋窝转移为首发表现的男性乳腺癌病例。
