Szabolcsi Orsolya, Nagy-Toldi Annamária, Zeher Margit, Végh Judit
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, III. sz. Belgyógyászati Klinika, Klinikai Immunológiai Tanszék, Debrecen, Hungary.
Magy Onkol. 2012 Mar;56(1):50-4. Epub 2011 Oct 3.
Scleroderma is the general disease of the connective tissue, which can be characterized by the proliferation of the connective tissue and fibrosis. According to the results of international studies scleroderma is frequently accompanied by neoplastic diseases, among which the most often occurring is the neoplastic pathology of the breast and the lungs. In May 2007, in the case of our 40-year-old woman patient the histological examination of the tumor we noticed in the left breast verified invasive carcinoma. In December 2007, after neoadjuvant chemotherapy she had a left mastectomy and then she was given postoperative irradiation, hormone therapy and trastuzumab (Herceptin) treatment, which was suspended in December 2008 due to oedema and fibrosis all over the body. In May 2009 she first visited the immunology outpatient department of our clinic, where we started her examination because of our suspicion of scleroderma and her cutaneous fibrosis symptoms, which was established on the basis of the examinations (immunoserology, body plethysmography, diffusing capacity of the lung for carbon monoxide, capillary microscopy, barium swallow) and her symptoms. She was given a conservative therapy (pentoxyphylline, amlodipine, nitroglycerin). Scleroderma arising after the neoplastic process of the breast is usually much more progressive than the primary disease. International reports also show a close correlation between breast cancer and the development of scleroderma, but its exact mechanism is not yet clear.
硬皮病是一种结缔组织的全身性疾病,其特征为结缔组织增生和纤维化。根据国际研究结果,硬皮病常伴有肿瘤性疾病,其中最常见的是乳腺和肺部的肿瘤性病变。2007年5月,在我们一名40岁女性患者的病例中,对左侧乳房发现的肿瘤进行组织学检查,证实为浸润性癌。2007年12月,新辅助化疗后她接受了左侧乳房切除术,随后接受了术后放疗、激素治疗和曲妥珠单抗(赫赛汀)治疗,2008年12月因全身水肿和纤维化而暂停治疗。2009年5月,她首次就诊于我们诊所的免疫科门诊,由于怀疑硬皮病以及她的皮肤纤维化症状,我们基于检查结果(免疫血清学、人体体积描记法、肺一氧化碳弥散量、毛细血管显微镜检查、吞钡检查)和她的症状开始对她进行检查。她接受了保守治疗(己酮可可碱、氨氯地平、硝酸甘油)。乳腺肿瘤性病变后出现的硬皮病通常比原发性疾病进展得更快。国际报告也显示乳腺癌与硬皮病的发生之间存在密切关联,但其确切机制尚不清楚。