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伴有罕见淋巴浆细胞浸润的乳腺纯黏液腺癌:一例报告并文献复习

Pure mucinous adenocarcinoma of the breast with the rare lymphoplasmacytic infiltration: A case report with review of literature.

作者信息

Prajapati Yash Hasmukhbhai, Bhabhor Vishal, Mehta Kahan Samirkumar, Barot Mithoon, Boriwala Husen, Omar Mohamed

机构信息

Department of General Surgery GMERS Medical College and Hospital Vadodara Gujarat India.

Department of Internal Medicine GMERS Medical College and Hospital Vadodara Gujarat India.

出版信息

Clin Case Rep. 2024 Mar 26;12(4):e8560. doi: 10.1002/ccr3.8560. eCollection 2024 Apr.

Abstract

KEY CLINICAL MESSAGE

A unique ER/PR-positive mucinous adenocarcinoma of breast but CK7/CK20 negativity. A rare finding of Lymphoplasmacytic Infiltration is noted. Successful treatment included modified radical mastectomy and tamoxifen-based therapy, leads to remission.

ABSTRACT

Mucinous carcinoma, which is characterized by the presence of abundant extracellular mucin, is a rare and distinctive subtype of invasive breast cancer. This subtype accounts for less than 5% of all invasive breast cancers, with pure mucinous carcinoma representing only around 2%. It is most commonly found in older patients, typically in the sixth to early eighth decade of life. We present the case of a 55-year-old female with a 15-year history of a painless, gradually enlarging palpable lump on her left breast. Upon examination, a 5 × 5 cm lump with well-defined margins and a hard consistency was found in the lower outer quadrant of the left breast. Histopathological examination confirmed a diagnosis of Mucinous Adenocarcinoma of the Left Breast. The patient underwent modified radical mastectomy and received adjuvant endocrine therapy with tamoxifen due to hormone receptor-positive status. Mucinous carcinoma of the breast is a unique entity with specific histological features including the presence of extracellular mucin pools. Immunohistochemical staining is crucial for determining hormone receptor status, which can guide treatment decisions. Although surgical intervention is the primary approach, the extent of surgery may vary, ranging from lumpectomy to mastectomy. Adjuvant therapies such as chemotherapy and radiotherapy may also be considered based on individual cases. This case underscores the importance of a multidisciplinary approach in managing rare subtypes of breast cancer, such as mucinous carcinoma. Accurate diagnosis, appropriate surgical intervention, adjuvant therapy, and long-term follow-up are critical components of treatment.

摘要

关键临床信息

一例独特的雌激素受体/孕激素受体(ER/PR)阳性的乳腺黏液腺癌,但细胞角蛋白7(CK7)/细胞角蛋白20(CK20)阴性。发现罕见的淋巴细胞浆细胞浸润。成功的治疗包括改良根治性乳房切除术和他莫昔芬治疗,病情缓解。

摘要

黏液腺癌以大量细胞外黏液的存在为特征,是浸润性乳腺癌中一种罕见且独特的亚型。该亚型占所有浸润性乳腺癌的比例不到5%,纯黏液腺癌仅占约2%。它最常见于老年患者,通常在60至80岁之间。我们报告一例55岁女性病例,其左乳有无痛、逐渐增大的可触及肿块,病史15年。检查发现左乳外下象限有一个5×5 cm的肿块,边界清晰,质地硬。组织病理学检查确诊为左乳黏液腺癌。由于激素受体阳性,患者接受了改良根治性乳房切除术,并接受了他莫昔芬辅助内分泌治疗。乳腺黏液腺癌是一种具有特定组织学特征的独特实体,包括细胞外黏液池的存在。免疫组化染色对于确定激素受体状态至关重要,可指导治疗决策。虽然手术干预是主要方法,但手术范围可能有所不同,从肿块切除到乳房切除。根据个体情况,也可考虑辅助化疗和放疗等治疗。该病例强调了多学科方法在管理罕见乳腺癌亚型(如黏液腺癌)中的重要性。准确诊断、适当的手术干预、辅助治疗和长期随访是治疗的关键组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a49b/10965451/642974fdfda2/CCR3-12-e8560-g005.jpg

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