Athanasiou Evangelia, Michalopoulou-Manoloutsiou Electra, Bobos Mattheos, Hatzibougias Dimitris I, Zarogoulidis Paul, Katsikogiannis Nikolos, Sarika Eirini, Karapantzos Ilias, Barbetakis Nikolaos, Paliouras Dimitrios, Chatzinikolaou Fotis, Charalampidis Charalampos, Kougioumtzi Ioanna, Kolettas Alexandros, Bakas Andreas, Tzelepi Keraso, Kalaitzis Efstratios, Tsakiridis Kosmas
"Microdiagnostics" Ltd., Thessaloniki, Greece.
Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ann Transl Med. 2016 Nov;4(22):446. doi: 10.21037/atm.2016.11.34.
We present a case of a 56-year-old female, with a familial history of breast, lung and brain cancer, which revealed a breast tumor, located in the upper outer quadrant of the left breast. During the routinely staging examinations, a 15 cm intrathoracic tumor was found in the upper left mediastinum, penetrating the pericardium and a smaller tumor, in the left side of parietal pleura. Core biopsies from both lesions, revealed a lobular carcinoma of the breast classic type, grade II (e-cadherin-, ER+, PR+, Her-2-, Ki-67 10%) and a B3 thymoma (CK19+, CD5+) penetrating the pericardium and the left lung. A synchronous removal of both tumors was scheduled, including median sternotomy and left intrapericardial pneumonectomy, followed by a modified radical left mastectomy and a sentinel lymph node biopsy. The postoperative course was uneventful. This case advocates that thymoma patients appear to have a predisposition towards developing additional neoplasms, as breast carcinoma. Clinicians should be aware of the increased incidence of extrathymic cancers, occurring in thymoma patients.
我们报告一例56岁女性病例,其有乳腺癌、肺癌和脑癌家族史,检查发现左乳外上象限有一个乳腺肿瘤。在常规分期检查中,发现左上纵隔有一个15厘米的胸内肿瘤,穿透心包,在壁层胸膜左侧还有一个较小的肿瘤。对两个病灶进行的核心活检显示,乳腺为经典型小叶癌,二级(E-钙黏蛋白阴性、雌激素受体阳性、孕激素受体阳性、人表皮生长因子受体2阴性、Ki-67为10%),胸腺为B3型胸腺瘤(细胞角蛋白19阳性、CD5阳性),穿透心包和左肺。计划同时切除这两个肿瘤,包括正中胸骨切开术和左心包内肺切除术,随后进行改良根治性左乳房切除术和前哨淋巴结活检。术后过程顺利。该病例表明,胸腺瘤患者似乎易患其他肿瘤,如乳腺癌。临床医生应意识到胸腺瘤患者发生胸腺外癌症的发生率增加。