Tomida Satomi, Nakatsukasa Katsuhiko, Taguchi Tetsuya
Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine.
Gan To Kagaku Ryoho. 2018 Sep;45(9):1381-1384.
A 63-year-old woman experienced left cervical lymph node swelling since May 2012. Based on PET-CT findings, metastases of a malignant tumor to the mediastinal, axillary, and left cervical lymph nodes were suspected. Her left cervical lymph node biopsy revealed metastatic carcinoma of occult cancer, because no primary tumor could be identified despite the specific examinations. She rejected further therapeutic intervention. In July 2013, she was admitted because of anemia, cardiac failure, and fever. She was diagnosed with bone marrow carcinomatosis from occult cancer based on her bone marrow biopsy. Metastatic breast cancer was mostly considered because she tested positive for estrogen and progesterone receptors, CA15-3 levels were increased, and her axillary lymph nodes were swollen. Fulvestrant and zoledronic acid were administered and continued for 20 months, with improvement in anemia and tumor marker levels, and also maintenance of partial response.
一名63岁女性自2012年5月起出现左侧颈部淋巴结肿大。基于PET-CT检查结果，怀疑恶性肿瘤转移至纵隔、腋窝及左侧颈部淋巴结。她的左侧颈部淋巴结活检显示为隐匿癌的转移性癌，因为尽管进行了详细检查仍未发现原发肿瘤。她拒绝了进一步的治疗干预。2013年7月，她因贫血、心力衰竭和发热入院。根据骨髓活检结果，她被诊断为隐匿癌导致的骨髓转移癌。由于她的雌激素和孕激素受体检测呈阳性、CA15-3水平升高且腋窝淋巴结肿大，故大多考虑为转移性乳腺癌。给予氟维司群和唑来膦酸治疗并持续了20个月，贫血和肿瘤标志物水平有所改善，部分缓解状态也得以维持。
