Xie Xintong, Kong Xiangyi, Jiang Hongnan, Gao Jidong
Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
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.
Front Oncol. 2025 Feb 11;15:1374032. doi: 10.3389/fonc.2025.1374032. eCollection 2025.
Male breast cancer is a rare neoplasm, accounting for approximately 1% of all breast cancer cases. It typically presents as a painless, retroareolar mass. An exceedingly rare variant is male occult breast cancer, which is primarily characterized by axillary lymph node enlargement without an identifiable primary breast tumor. We report an intriguing case of a septuagenarian patient diagnosed with male occult breast cancer. The patient presented with both axillary lymph node enlargement and an associated axillary skin ulcer, and was subsequently diagnosed with male occult breast cancer with metastases to the axillary and clavicular lymph nodes, as well as more distant sites. His treatment involved a multidisciplinary approach, including HER2-targeted therapy, chemotherapy, axillary lymph node dissection, and radiotherapy. Regular follow-ups have shown that his condition remains stable. Notably, this is the first documented case of male occult breast cancer with distant metastasis that was successfully treated with surgery and radiotherapy following systemic therapy. This case highlights the complex clinical presentation and management of male occult breast cancer. Our findings suggest that surgical intervention may be a feasible option post-downstaging by systemic therapy, even in the presence of distant metastases.
男性乳腺癌是一种罕见的肿瘤，约占所有乳腺癌病例的1%。它通常表现为无痛性乳晕后肿块。一种极其罕见的变异类型是男性隐匿性乳腺癌，其主要特征是腋窝淋巴结肿大而无明确的原发性乳腺肿瘤。我们报告了一例有趣的病例，一名老年男性患者被诊断为男性隐匿性乳腺癌。该患者表现为腋窝淋巴结肿大及相关的腋窝皮肤溃疡，随后被诊断为男性隐匿性乳腺癌，已转移至腋窝和锁骨淋巴结以及更远处的部位。他的治疗采用了多学科方法，包括HER2靶向治疗、化疗、腋窝淋巴结清扫和放疗。定期随访显示他的病情保持稳定。值得注意的是，这是第一例有文献记载的男性隐匿性乳腺癌伴远处转移的病例，在全身治疗后通过手术和放疗成功治愈。该病例突出了男性隐匿性乳腺癌复杂的临床表现和治疗方法。我们的研究结果表明，即使存在远处转移，手术干预在全身治疗降期后可能是一种可行的选择。
