Takada Koji, Miyashita Masae, Kawajiri Hidemi
Dept. of Breast Surgery, Ishikiriseiki Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2213-2215.
An 89-year-old male was diagnosed with advanced gastric cancer during an upper gastrointestinal endoscopy for gastric polyp follow-up. Positron emission tomography revealed tumors with 18F-fluorodeoxyglucose(FDG)accumulation in the right lung and right breast. Incisional biopsy of the right breast tumor was performed and the tumor was diagnosed as primary breast cancer(ER: 90%, PgR: 70%, HER2: 1+, Ki-67: 17%). Since it was difficult to distinguish whether the lung tumor was primary lung cancer or metastasis, a bronchoscopic biopsy was performed. Histopathological examination revealed that the lung tumor was primary lung cancer. Thus, this male patient had simultaneous triple gastric, breast, and lung cancer. Total mastectomy was performed for the breast cancer under local anesthesia and adjuvant endocrine therapy was started. Stereo- tactic body radiation therapy(48 Gy/4 Fr/4 days)for lung cancer and partial gastrectomy for gastric cancer were subsequently performed. Although male breast cancer itself is rare, we experienced a very rare case of male breast cancer with simultaneous lung and gastric cancer.
一名89岁男性在因胃息肉随访进行上消化道内镜检查时被诊断为晚期胃癌。正电子发射断层扫描显示右肺和右乳有18F-氟脱氧葡萄糖（FDG）摄取的肿瘤。对右乳肿瘤进行了切开活检，诊断为原发性乳腺癌（雌激素受体：90%，孕激素受体：70%，人表皮生长因子受体2：1+，Ki-67：17%）。由于难以区分肺部肿瘤是原发性肺癌还是转移瘤，遂进行了支气管镜活检。组织病理学检查显示肺部肿瘤为原发性肺癌。因此，该男性患者同时患有三重癌症，即胃癌、乳腺癌和肺癌。在局部麻醉下对乳腺癌实施了全乳切除术，并开始辅助内分泌治疗。随后对肺癌进行了立体定向体部放射治疗（48 Gy/4次/4天），对胃癌进行了部分胃切除术。虽然男性乳腺癌本身较为罕见，但我们遇到了一例非常罕见的同时患有肺癌和胃癌的男性乳腺癌病例。
