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男性患者乳腺浸润性微乳头状癌:病例报告

Invasive micropapillary carcinoma of the breast in a male patient: Report of a case.

作者信息

Tsushimi Takaaki, Mori Hirohito, Harada Takasuke, Ikeda Yoshitaka, Ohnishi Hiromi

机构信息

Ehime Rosai Hospital, Department of Surgery and Department of Pathology, Minamikomatsubara-cho 13-27, Niihama, Ehime 792-8550, Japan.

出版信息

Int J Surg Case Rep. 2013;4(11):988-91. doi: 10.1016/j.ijscr.2013.09.001. Epub 2013 Sep 9.

Abstract

INTRODUCTION

We report a rare case of invasive micropapillary carcinoma in the male breast.

PRESENTATION OF CASE

A 63-year-old man was referred to our hospital for investigation of a left breast tumor, which could be palpated in the upper lateral quadrant of the left nipple-areola complex. The tumor invaded the areola skin. Ultrasonography showed a 14.8×15.0×12.4mm low echoic mass, with an irregular lobulated border. Core needle biopsy indicated invasive ductal carcinoma, but the subtype could not be accurately determined. Mastectomy with axillary lymph node dissection was performed. Pathological examination indicated invasive micropapillary carcinoma, no lymph node metastasis, and a nuclear grade of 2. Immunohistochemical examination showed positive staining for estrogen and progesterone receptors, but negative staining for HER2. The Ki67 index was 5%. Tamoxifen was administered, and recurrence has not been noted for 1 year.

DISCUSSION

Women's IMPC generally shows a high HER2 positivity rate. However, HER2 positivity was noted in only 1 male patient with IMPC (14%) according to our literature review. Furthermore, in all cases of the mixed type that were reviewed, IMPC was associated with papillotubular carcinoma. These findings may be specific to IMPC in male patients.

CONCLUSION

IMPC is associated with a high rate of lymph node metastasis or recurrence and advanced vessel invasion, aggressive adjuvant chemotherapy following surgical resection should be selected for patients with IMPC.

摘要

引言

我们报告一例男性乳腺浸润性微乳头状癌的罕见病例。

病例介绍

一名63岁男性因左侧乳腺肿瘤前来我院就诊,该肿瘤可在左侧乳头乳晕复合体的外上象限触及。肿瘤侵犯乳晕皮肤。超声检查显示一个14.8×15.0×12.4mm的低回声肿块,边界呈不规则分叶状。粗针穿刺活检提示浸润性导管癌,但无法准确确定亚型。遂行乳房切除术及腋窝淋巴结清扫术。病理检查显示为浸润性微乳头状癌,无淋巴结转移,核分级为2级。免疫组化检查显示雌激素和孕激素受体呈阳性染色,但HER2呈阴性染色。Ki67指数为5%。给予他莫昔芬治疗,1年内未发现复发。

讨论

女性浸润性微乳头状癌(IMPC)通常显示HER2阳性率较高。然而,根据我们的文献综述,仅有1例男性IMPC患者(14%)出现HER2阳性。此外,在所有回顾的混合型病例中,IMPC均与乳头管状癌相关。这些发现可能是男性患者IMPC所特有的。

结论

IMPC与高淋巴结转移率或复发率以及血管侵犯有关,对于IMPC患者,手术切除后应选择积极的辅助化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c74d/3825973/af049cccbb96/gr1.jpg

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