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[一例疑似胰腺癌乳腺转移的男性乳腺癌病例]

[A Case of Male Breast Cancer Suspected of Breast Metastasis from Pancreatic Cancer].

作者信息

Takada Koji, Kashiwagi Shinichiro, Amano Ryosuke, Goto Wataru, Asano Yuka, Ohira Go, Yamazoe Sadaaki, Kimura Kenjiro, Noda Satoru, Takashima Tsutomu, Onoda Naoyoshi, Hirakawa Kosei, Ohira Masaichi

机构信息

Dept. of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2018 Dec;45(13):1857-1859.

Abstract

History of male breast cancer and pancreatic cancer are important for diagnosis of hereditary breast and ovarian cancer syndrome(HBOC), while advanced pancreatic cancer is reported to have metastasis to mammary gland tissue. A 67-year-old man visited a local hospital because fever and right hypochondrial pain. Computed tomography scan revealed pancreatic cancer with multiple liver metastasis and peritoneal metastasis. He was referred to our hospital for further evaluation and treatment. No particular family history of malignancy was formed. A palpable lump was found in his left breast. Ultrasonography revealed 2.8 cm sized mass that had heterogenous internal echo and rough border. The background mammary gland showed gynecomastia. Since it was difficult primary breast cancer with metastatic tumor originated from pancreas cancer a core needle biopsy was performed. The finding of pathological examination showed invasive carcinoma with hormonal receptor negative and HER2 negative feature. CK7 and CK19 were both positive. Although it was difficult to male differentiation whether the tumor was primary a metastatic, we diagnosed as synchronous duplicated cancer of pancreas and breast due to existence of gynecomastia. Since hepatic failure due to tumor growth advanced prior to treatment start, the treatment policy became best supportive care.

摘要

男性乳腺癌和胰腺癌病史对于遗传性乳腺癌和卵巢癌综合征(HBOC)的诊断很重要,而据报道晚期胰腺癌可转移至乳腺组织。一名67岁男性因发热和右季肋部疼痛前往当地医院就诊。计算机断层扫描显示胰腺癌伴多发肝转移和腹膜转移。他被转诊至我院进行进一步评估和治疗。未发现特殊的恶性肿瘤家族史。在他的左侧乳房发现一个可触及的肿块。超声检查显示一个大小为2.8厘米的肿块,内部回声不均匀,边界粗糙。乳腺背景显示男性乳房发育。由于难以判断是原发性乳腺癌还是源自胰腺癌的转移瘤,遂进行了粗针穿刺活检。病理检查结果显示为浸润性癌,激素受体阴性且HER2阴性。CK7和CK19均为阳性。尽管难以区分肿瘤是原发性还是转移性,但由于存在男性乳房发育,我们诊断为胰腺和乳腺同步双原发癌。由于在开始治疗前肿瘤生长导致肝功能衰竭进展,治疗策略变为最佳支持治疗。

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