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一名有乳腺癌家族史的女性,纤维腺瘤中发生癌变:病例报告及文献复习

Carcinoma developing in a fibroadenoma in a woman with a family history of breast cancer: a case report and review of literature.

作者信息

Khandelwal Rohan, Tandon Megha, Yashwant K, Kulshreshtha Pranjal, Aeron Tushar, Bhatnagar Dinesh, Bansal Anju, Saxena Sunita

机构信息

Department of Surgery, Vardhman Mahavir Medical College, Safdarjang Hospital, New Delhi-110023, India.

出版信息

Cases J. 2009 Dec 18;2:9348. doi: 10.1186/1757-1626-2-9348.

Abstract

INTRODUCTION

Malignant transformation of a fibroadenoma is rare with only about 100 cases reported in the world literature. Fibroadenoma occurring in middle aged woman with a strong family history of breast or ovarian cancer should be investigated with a high suspicion for malignancy.

CASE PRESENTATION

A 35-year- old Indian lady operated previously for fibroadenoma of the right breast presented with a recurrent lump at the same site. She had a strong family history of breast carcinoma. Mammography and trucut biopsy was suggestive of infiltrating duct carcinoma. She was managed by lumpectomy and axillary lymph node dissection with a satisfactory outcome. There was no evidence of BRCA-1, BRCA-2 mutation on immunohistochemistry.

CONCLUSION

Malignant change in a pre-existing fibroadenoma is rare, however in a middle aged woman with a family history of breast cancer it should be suspected. In the absence of any definite clinical and radiological criteria of diagnosing malignant change in a fibroadenoma, high suspicion index is mandatory. The management and outcome depends on the stage and grade of presentation.

摘要

引言

纤维腺瘤的恶性转化极为罕见,世界文献中仅报道了约100例。发生于有乳腺癌或卵巢癌家族史的中年女性的纤维腺瘤,应高度怀疑为恶性并进行检查。

病例报告

一名35岁的印度女性,曾因右乳纤维腺瘤接受手术,现于同一部位出现复发性肿块。她有乳腺癌家族史。乳房X线摄影和粗针活检提示浸润性导管癌。她接受了肿块切除术和腋窝淋巴结清扫术,结果令人满意。免疫组织化学检查未发现BRCA-1、BRCA-2突变。

结论

既往存在的纤维腺瘤发生恶性变很罕见,但对于有乳腺癌家族史的中年女性应予以怀疑。在缺乏诊断纤维腺瘤恶性变的确切临床和影像学标准的情况下,必须保持高度怀疑指数。治疗方法和结果取决于病变的分期和分级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12d6/2806393/59e39d0fa2ac/1757-1626-2-9348-1.jpg

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