乳腺原发性巨细胞瘤伴肺转移:一例报告及文献复习

Primary Giant Cell Tumor of the Breast With Pulmonary Metastasis: A Case Report and Review of the Literature.

作者信息

Zhang Wenxiang, Kong Xiangyi, Qi Yihang, Wang Xiangyu, Liu Qiang, Fang Yi, Song Yan, Wang Jing

机构信息

Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Oncol. 2021 Nov 5;11:638237. doi: 10.3389/fonc.2021.638237. eCollection 2021.

Abstract

Giant cell tumor of soft tissue (GCT-ST) is an extremely rare tumor that is similar in morphology and immunohistochemistry to giant cell tumor of the bone. Almost 80% of these tumors occur in the upper and lower extremities, and the breast is a very rare location. Here, we report a case of a 65-year-old female patient with a small mobile palpable lump in the left breast. Although the left breast tumor was considered malignant on preoperative imaging, no evidence of malignant tumor was found by ultrasound-guided core needle biopsy (CNB). Subsequently, the left breast tumor was confirmed as a malignant tumor by intraoperative rapid pathological examination. The initial treatment of the tumor was wide local excision and sentinel lymph node biopsy, and it was confirmed to be GCT-ST by histopathology and immunohistochemistry. Despite surgical treatment achieving clear surgical margins, the patient experienced lung metastases within a year of her initial treatment. Fortunately, the patient underwent surgical treatment of lung metastases, and at the last follow-up, the patient was still alive. This is the first case of a primary soft tissue tumor of the breast that has undergone surgical intervention after lung metastasis. This case report highlights the complexity of the clinical diagnosis and treatment of GCT-ST arising from the breast. Surgery may be another good treatment when the patient develops lung metastases.

摘要

软组织巨细胞瘤(GCT-ST)是一种极其罕见的肿瘤,在形态学和免疫组织化学方面与骨巨细胞瘤相似。这些肿瘤近80%发生于上肢和下肢,而乳腺是非常罕见的发病部位。在此,我们报告一例65岁女性患者,其左乳可触及一个可活动的小结节。尽管术前影像学检查认为左乳肿瘤为恶性,但超声引导下粗针穿刺活检(CNB)未发现恶性肿瘤证据。随后,术中快速病理检查证实左乳肿瘤为恶性肿瘤。肿瘤的初始治疗为广泛局部切除和前哨淋巴结活检,组织病理学和免疫组织化学检查确诊为GCT-ST。尽管手术治疗获得了切缘阴性,但患者在初始治疗后一年内出现了肺转移。幸运的是,患者接受了肺转移灶的手术治疗,最后一次随访时患者仍存活。这是首例乳腺原发性软组织肿瘤肺转移后接受手术干预的病例。本病例报告突出了乳腺来源的GCT-ST临床诊断和治疗的复杂性。当患者发生肺转移时,手术可能是另一种较好的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73a7/8602786/a9b87643d875/fonc-11-638237-g001.jpg

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