Kumar Nilkamal, Pandey A N, Kumari Swasty, Kishore Sanjeev
Department of Surgery, Endocrine Division SGRRIMHS, Patel Nagar, Deharadoon, Uttarakhand 248001 India.
Department of Medicine, Internal Medicine SGRRIMHS, Patel Nagar, Deharadoon, Uttarakhand 248001 India.
Indian J Surg Oncol. 2014 Sep;5(3):205-7. doi: 10.1007/s13193-014-0327-2. Epub 2014 Jul 3.
Breast cancer in association with type- 1 neurofibromatosis (NF1) is a rare clinical entity. Here, we present the case of a 45-year-old woman with typical clinical manifestations of NF1, who presented with a right breast lump, which she had first noticed 8 months back but had disregarded, believing it to be another manifestation of her Von Recklinghausen's disease. Clinical examination and diagnostic workup were suggestive of a breast carcinoma. Subsequently, she underwent modified radical mastectomy, followed by postoperative chemotherapy. Histopathological examination revealed high grade invasive duct carcinoma and multiple neurofibromas. After 7.5 months, she developed recurrence at the drain site with pulmonary and bony metastasis and died 9 months after surgery. Delayed presentation of the patient was the result of her mistaken identification for the breast tumor as a manifestation of NF-1. Early onset, high grade tumor and early recurrence with metastasis place strong emphasis on clinical alertness and to opt for an aggressive treatment option.
与1型神经纤维瘤病(NF1)相关的乳腺癌是一种罕见的临床实体。在此,我们报告一例45岁女性患者,她具有NF1的典型临床表现,因右乳肿块前来就诊,该肿块她8个月前首次发现,但未予重视,认为是其冯雷克林霍增氏病的另一种表现。临床检查和诊断性检查提示为乳腺癌。随后,她接受了改良根治性乳房切除术,术后进行了化疗。组织病理学检查显示为高级别浸润性导管癌和多个神经纤维瘤。7.5个月后,她在引流部位出现复发,并伴有肺和骨转移,术后9个月死亡。患者就诊延迟是因为她将乳腺肿瘤错误地认定为NF-1的一种表现。肿瘤发病早、级别高且早期复发并伴有转移,这强烈强调了临床警惕性,并应选择积极的治疗方案。