Hayashi Satoshi, Kitada Masahiro, Matsuda Yoshinari, Ishibashi Kei, Takahashi Nana
Breast Center, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510 Japan.
Surg Case Rep. 2015;1(1):76. doi: 10.1186/s40792-015-0072-y. Epub 2015 Sep 7.
Radiation therapy (RT) is considered a risk factor for the development of sarcoma in patients with breast cancer. However, there are few reports regarding post-irradiation sarcoma (PIS).
The patient was a 59-year-old woman who presented with a chief complaint of induration in the lower outer quadrant of the left breast. She underwent breast-conserving surgery (BCS) for breast cancer located in the left upper inner region and received endocrine therapy following RT (50 Gy/25 fractions/5 weeks) for breast conservation 6 years previously. Core needle biopsy revealed leiomyosarcoma. There was no distant metastasis. Repeat BCS including part of the pectoralis major muscle was performed. Chest wall resection was not performed because of the lack of invasion. Based on the morphological and immunohistochemical features, a diagnosis of leiomyosarcoma was made. All of the resection margins in the specimen were tumor-free. She has been disease-free for over 20 months.
Post-irradiation leiomyosarcoma is an extremely rare tumor with high malignant potential, and thus, multidisciplinary therapy and close follow-up are advised.
放射治疗（RT）被认为是乳腺癌患者发生肉瘤的一个危险因素。然而，关于放疗后肉瘤（PIS）的报道很少。
患者为一名59岁女性，主要主诉为左乳房外下象限硬结。她因左乳房内上区域的乳腺癌接受了保乳手术（BCS），并在6年前接受了保乳放疗（50 Gy/25次分割/5周）后接受了内分泌治疗。粗针活检显示为平滑肌肉瘤。无远处转移。进行了包括部分胸大肌的再次保乳手术。由于没有侵犯，未进行胸壁切除。根据形态学和免疫组化特征，诊断为平滑肌肉瘤。标本中所有切除边缘均无肿瘤。她已无病生存超过20个月。
放疗后平滑肌肉瘤是一种极其罕见的具有高恶性潜能的肿瘤，因此，建议采用多学科治疗并密切随访。
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