Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, China.
Ann Palliat Med. 2021 Jul;10(7):8467-8473. doi: 10.21037/apm-20-2561. Epub 2021 May 19.
Radiation-associated leiomyosarcoma has a poor prognosis. Fewer than 20 cases of radiation-associated leiomyosarcoma of the breast have been reported in the literature to date. We report the first case of recurrent radiation-associated leiomyosarcoma after invasive ductal carcinoma postoperative radiotherapy. A 45-year-old female patient with no familial history of cancer underwent breast-conserving surgery (BCS) and dissection of axillary lymph nodes for invasive ductal carcinoma in the right upper outer region in 2014. After the operation, she received adjuvant chemotherapy followed by radiotherapy and endocrine therapy. She came to our institution for a lump in the right breast radiation region in 2019. Ultrasonography revealed an oval mass, with ill-defined borders, irregular margins, and speculation at 6 o'clock direction of the right breast, approximately 2.5 cm from the nipple. Ultimately, excisional biopsy established the pathological diagnosis of leiomyosarcoma. The female then underwent simple mastectomy of the right breast. The patient received no radiation or chemotherapy after the simple mastectomy. After 13 months of follow-up, a lump was found in the right chest wall and axillary levels of the radiation region. Excisional biopsy confirmed the pathological diagnosis of leiomyosarcoma. This rare case indicated that simple mastectomy seemed to be inadequate treatment for radiation-associated leiomyosarcoma.
放射相关性平滑肌肉瘤预后不良。迄今为止，文献中仅报道了不到 20 例乳腺放射相关性平滑肌肉瘤病例。我们报告首例浸润性导管癌术后放疗后复发性放射相关性平滑肌肉瘤。一名 45 岁女性患者，无癌症家族史，于 2014 年在外上象限行乳腺癌保乳手术（BCS）和腋窝淋巴结清扫术。术后她接受了辅助化疗，然后接受了放疗和内分泌治疗。2019 年，她因右乳放疗区肿块来我院就诊。超声检查显示右乳 6 点钟方向距乳头约 2.5 厘米处有一个边界不清、边缘不规则、推测为椭圆形肿块。最终，切除活检确立了平滑肌肉瘤的病理诊断。随后，该女性接受了单纯右乳切除术。单纯乳房切除术后，患者未接受放疗或化疗。随访 13 个月后，在右胸壁和腋窝放疗区发现肿块。切除活检证实了平滑肌肉瘤的病理诊断。这一罕见病例表明，单纯乳房切除术似乎不足以治疗放射相关性平滑肌肉瘤。
