Kondo Senri, Oura Shoji
Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada-city, Osaka 596-8522, Japan.
Radiol Case Rep. 2024 Sep 21;19(12):6093-6096. doi: 10.1016/j.radcr.2024.09.067. eCollection 2024 Dec.
A 66-year-old woman with metastatic mucinous breast cancer was referred to our hospital. The patient had lymph node and multiple lung metastases judged as progressive disease. Positron emission tomography showed radio tracer uptake neither in the axillary lymph nodes nor in the lung metastases. Chemotherapy brought about marked regression of the lymph node and lung metastases. Pathological study of the regressed but still swollen metastatic axillary lymph nodes showed no viable cancer cells with fibrosis and abundant mucin. Multidisciplinary treatment including chemotherapy followed by endocrine therapy fortunately resulted in complete response of the lung lesions. The patient has been well on endocrine therapy for more than 3 years without any image detectable cancer foci. Diagnostic physicians should note that the presence of mucin in mucinous breast cancers can cause underestimation of tumor viability assessment with positron emission tomography and therapeutic efficacy assessment with various image modalities.
一名66岁的转移性黏液性乳腺癌女性被转诊至我院。患者有淋巴结和多处肺转移，被判定为疾病进展。正电子发射断层扫描显示腋窝淋巴结和肺转移灶均无放射性示踪剂摄取。化疗使淋巴结和肺转移灶明显消退。对消退但仍肿大的转移性腋窝淋巴结进行病理研究，结果显示无存活癌细胞，伴有纤维化和大量黏液。包括化疗后内分泌治疗在内的多学科治疗幸运地使肺部病变完全缓解。该患者接受内分泌治疗已超过3年，未发现任何影像学可检测到的癌灶。诊断医师应注意，黏液性乳腺癌中黏液的存在可能导致正电子发射断层扫描对肿瘤存活能力评估以及各种影像检查方式对治疗效果评估的低估。
