Mehta Krisha K, Nouvini Rosa, Liu Jingxuan, Wang Yi, Stopeck Alison
Department of Medicine, Stony Brook University, Stony Brook, NY, United States.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Front Oncol. 2023 Jan 5;12:1061679. doi: 10.3389/fonc.2022.1061679. eCollection 2022.
Breast cancer with choriocarcinomatous features (BCCF) is a rare and aggressive breast cancer. BCCF carries a poor prognosis and there is unfortunately scant literature to guide treatment beyond surgical resection with most patients receiving standard regimens for breast cancer. In our case, we present a 42-year-old female with an initial hCG of 2,324 and two suspicious lesions of the right breast. On biopsy, each lesion had distinct histopathology with the larger lesion diagnosed as BCCF and the smaller lesion being an invasive ER/PR positive ductal carcinoma. The diagnosis of BCCF rather than metastatic choriocarcinoma was confirmed using DNA typing. Salvage chemotherapy targeting choriocarcinoma resulted in marked clinical and biomarker success including normalization of the hCG. After recurrent brain metastases were diagnosed, high dose chemotherapy with methotrexate was administered resulting in long term remission.
具有绒毛膜癌特征的乳腺癌（BCCF）是一种罕见且侵袭性强的乳腺癌。BCCF预后较差，遗憾的是，除手术切除外，几乎没有文献可指导治疗，大多数患者接受乳腺癌的标准治疗方案。在我们的病例中，我们报告了一名42岁女性，初始人绒毛膜促性腺激素（hCG）为2324，右乳有两个可疑病灶。活检时，每个病灶具有不同的组织病理学特征，较大的病灶诊断为BCCF，较小的病灶为浸润性雌激素受体/孕激素受体（ER/PR）阳性导管癌。通过DNA分型确诊为BCCF而非转移性绒毛膜癌。针对绒毛膜癌的挽救性化疗取得了显著的临床和生物标志物疗效，包括hCG恢复正常。在诊断出复发性脑转移后，给予大剂量甲氨蝶呤化疗，实现了长期缓解。
