Takayama Shin, Satomi Kaishi, Yoshida Masayuki, Watase Chikashi, Murata Takeshi, Shiino Sho, Jimbo Kenjiro, Suto Akihiko
National Cancer Center Hospital, Breast Surgery Division, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
National Cancer Center Hospital, Breast Surgery Division, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Int J Surg Case Rep. 2019;63:75-79. doi: 10.1016/j.ijscr.2019.09.017. Epub 2019 Sep 20.
Spontaneous regression of a malignant tumor is defined as "the partial or complete disappearance of a malignant tumor in the absence of any treatment." Herein, we report a case of occult breast cancer with axillary lymph node metastasis that showed spontaneous tumor regression based on the histopathological findings.
A 67-year-old woman presented with left armpit pain and a lump. Previous examination by another doctor revealed swelling of the left axillary lymph node, but it was difficult to identify the primary lesion. Needle biopsy of the left axillary lymph node revealed malignant tumor tissue with extensive necrosis on histological examination. On initial examination at our hospital, the left axillary lymph node was observed to have shrunk compared to previous observations. Moreover, findings indicated a suspected concentrated cyst in the left breast, with slight contrast enhancement on magnetic resonance imaging. Considering a diagnosis of occult breast cancer with axillary lymph node metastasis, excisional biopsy was performed for the left breast mass and axillary lymph node dissection for left axillary lymph node metastasis. Histological examination revealed a micro adenocarcinoma with lymphocyte infiltration in the left breast, and the viable tumor in the left axillary lymph node had disappeared. The histopathological findings of the primary tumor and dissected lymph nodes suggested the possibility of spontaneous regression of both the primary and metastatic lesions, because effective preoperative therapy was not performed.
恶性肿瘤的自发消退被定义为“在未进行任何治疗的情况下，恶性肿瘤部分或完全消失”。在此，我们报告一例隐匿性乳腺癌伴腋窝淋巴结转移病例，根据组织病理学检查结果显示肿瘤自发消退。
一名67岁女性因左腋窝疼痛和肿块就诊。另一位医生之前的检查发现左腋窝淋巴结肿大，但难以确定原发病灶。左腋窝淋巴结穿刺活检组织病理学检查显示为恶性肿瘤组织，伴有广泛坏死。在我院初诊时，观察到左腋窝淋巴结较之前缩小。此外，检查结果提示左乳疑似有密集囊肿，磁共振成像有轻微对比增强。考虑诊断为隐匿性乳腺癌伴腋窝淋巴结转移，对左乳肿块进行切除活检，对左腋窝淋巴结转移灶进行腋窝淋巴结清扫。组织病理学检查显示左乳为微腺癌伴淋巴细胞浸润，左腋窝淋巴结中的存活肿瘤已消失。由于未进行有效的术前治疗，原发肿瘤和清扫淋巴结的组织病理学检查结果提示原发灶和转移灶均有自发消退的可能。
