Bi Minglei, Li Danyi, Su Yipeng, Sun Pengfei, Gao Yan
Department of Plastic Surgery, The Affiliated Hospital of Qingdao University.
General Surgery, Qingdao West Coast New Area Central Hospital, Qingdao, China.
Medicine (Baltimore). 2020 Mar;99(11):e19506. doi: 10.1097/MD.0000000000019506.
Accessory breast cancer is extremely rare among all cancerous diseases, especially in male patients. There were only few male axillary accessory breast cancer cases that have been reported in scientific literatures so far. Hereby, we would like to discuss a case of male axillary accessory breast cancer found in our hospital.
We report a male senile patient suffering from a painful, enlarged, and hardened right axillary mass for more than 20 years. He came for further treatments due to progressive growth of the mass for 11 months with bloody ulceration for more than 1 month.
Pathological examination manifested a grade II infiltrating ductal carcinoma derived from the accessory mammary gland (right axilla), with invasion of local skin. Immunohistochemical examination result: estrogen receptor (++) 90%, progesterone receptor (+++) 100%, human epidermal growth factor receptor-2 (1+), ki67 (20% positive), prostate specific antigen (-), caudal-related homeobox-2 (-), thyroid transcription factor-1 (-), Synaptophysin (+), NapsinA (1), and CK7 (-).
Modified radical mastectomy and axillary lymph nodes clearance were performed on the accessary breast cancer under general anesthesia. Postoperatively, endocrine therapy was provided for the patient, orally-taken Letrozole was recommended for the rest of the patient's life.
The patient recovered uneventfully and was discharged 3 days after the operation. The patient continued to take Letrozole orally regularly at home and no signs of recurrence were observed.
Axillary accessory breast cancer in males is extremely rare, with no conspicuous and typical clinical presentations, which leads to inevitable neglect by clinicians. Therefore, there is significant necessity for clinicians to be cautious with this type of disease.
副乳腺癌在所有癌症疾病中极为罕见,尤其是在男性患者中。迄今为止,科学文献中仅报道了少数男性腋窝副乳腺癌病例。在此,我们将讨论我院发现的一例男性腋窝副乳腺癌病例。
我们报告一名老年男性患者,右侧腋窝肿块疼痛、肿大且变硬超过20年。因肿块持续增长11个月且伴有1个多月的血性溃疡前来进一步治疗。
病理检查显示为源自副乳腺(右腋窝)的II级浸润性导管癌,侵犯局部皮肤。免疫组化检查结果:雌激素受体(++)90%,孕激素受体(+++)100%,人表皮生长因子受体-2(1+),ki67(20%阳性),前列腺特异性抗原(-),尾型相关同源框-2(-),甲状腺转录因子-1(-),突触素(+),NapsinA(-),细胞角蛋白7(-)。
在全身麻醉下对副乳腺癌患者实施改良根治性乳房切除术及腋窝淋巴结清扫术。术后为患者提供内分泌治疗,建议患者终生口服来曲唑。
患者恢复顺利,术后3天出院。患者在家中继续规律口服来曲唑,未观察到复发迹象。
男性腋窝副乳腺癌极为罕见,无明显典型临床表现,易被临床医生忽视。因此,临床医生对这类疾病保持谨慎非常必要。