乳腺葉状腫瘍切除後6年目に発症した孤立性肺転移の1切除例
症例は54歳女性．他院で左乳腺葉状腫瘍に対して手術施行後，経過観察され，再発を指摘されていなかった．乳腺腫瘍術後6年目に咳嗽，胸部圧迫感を認めた．胸部CT上，左肺上葉中枢側を主座に内部不均一な長径16 cmの腫瘤影を認めた．CTガイド下生検を施行し，紡錘形細胞腫瘍を認めた．他臓器に転移病巣を認めず手術の方針となった．審査胸腔鏡検査で播種病変を認めず切除可能と判断した．左主肺動脈への腫瘍浸潤があり，胸骨正中切開でアプローチし左肺全摘除を施行した．最終病理診断で，肺腫瘍は乳腺葉状腫瘍の肺転移であった．乳腺葉状腫瘍は比較的まれな腫瘍であり，予後は比較的良好とされているが，再発症例や悪性転化症例の報告...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 31; no. 1; pp. 81 - 86 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.31.81 |
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| Abstract | 症例は54歳女性．他院で左乳腺葉状腫瘍に対して手術施行後，経過観察され，再発を指摘されていなかった．乳腺腫瘍術後6年目に咳嗽，胸部圧迫感を認めた．胸部CT上，左肺上葉中枢側を主座に内部不均一な長径16 cmの腫瘤影を認めた．CTガイド下生検を施行し，紡錘形細胞腫瘍を認めた．他臓器に転移病巣を認めず手術の方針となった．審査胸腔鏡検査で播種病変を認めず切除可能と判断した．左主肺動脈への腫瘍浸潤があり，胸骨正中切開でアプローチし左肺全摘除を施行した．最終病理診断で，肺腫瘍は乳腺葉状腫瘍の肺転移であった．乳腺葉状腫瘍は比較的まれな腫瘍であり，予後は比較的良好とされているが，再発症例や悪性転化症例の報告もある．今回我々は乳腺葉状腫瘍術後6年の経過で，左肺に孤立性に肺転移した症例に対して完全切除し得たので，若干の文献的考察を加え報告する． |
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| AbstractList | 症例は54歳女性．他院で左乳腺葉状腫瘍に対して手術施行後，経過観察され，再発を指摘されていなかった．乳腺腫瘍術後6年目に咳嗽，胸部圧迫感を認めた．胸部CT上，左肺上葉中枢側を主座に内部不均一な長径16 cmの腫瘤影を認めた．CTガイド下生検を施行し，紡錘形細胞腫瘍を認めた．他臓器に転移病巣を認めず手術の方針となった．審査胸腔鏡検査で播種病変を認めず切除可能と判断した．左主肺動脈への腫瘍浸潤があり，胸骨正中切開でアプローチし左肺全摘除を施行した．最終病理診断で，肺腫瘍は乳腺葉状腫瘍の肺転移であった．乳腺葉状腫瘍は比較的まれな腫瘍であり，予後は比較的良好とされているが，再発症例や悪性転化症例の報告もある．今回我々は乳腺葉状腫瘍術後6年の経過で，左肺に孤立性に肺転移した症例に対して完全切除し得たので，若干の文献的考察を加え報告する． |
| Author | 東条, 尚 河合, 紀和 川口, 剛史 安川, 元章 |
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| References | 3. Tse GM, Niu Y, Shi HJ. Phyllodes tumor of the breast: an update. Breast Cancer 2010; 17: 29-34. 8. Reinfuss M, Mituś J, Duda K, Stelmach A, Ryś J, Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996; 77: 910-6. 13. Asoglu O, Ugurlu MM, Blanchard K, Grant CS, Reynolds C, Cha SS, et al. Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol 2004; 11: 1011-7. 12. Macdonald OK, Lee CM, Tward JD, Chappel CD, Gaffney DK. Malignant phyllodes tumor of the female breast: association of primary therapy with cause-specific survival from the surveillance, epidemiology, and end results (SEER) program. Cancer 2006; 107: 2127-33. 11. Grabowski J, Salzstein SL, Sadler GR, Blair SL. Malignant phyllodes tumors: a review of 752 cases. Am Surg 2007; 73: 967-9. 19. Akcakaya A, Koc B, Erozgen F, Memmi N, Hot S, Yildiz MK, et al. Unpredictable behavior of breast phyllodes tumors. Eur Rev Med Pharmacol Sci 2014; 18: 2655-61. 22. Xiao M, Zhu Q, Jiang Y, Li J, Wang H, Zhang J, et al. Local recurrent phyllodes tumors of the breast: Clinical and sonographic features. J Ultrasound Med 2015; 34: 1631-8. 24. Ganti S, Svennevik E, Ali FS, Anikin V. Successful resection of giant solitary pulmonary metastasis from a phyllodes tumor. Ann Throac Surg 2007; 84: 1750-2. 1. Tan PH, Thike AA, Tan WJ, Thu MM, Busmanis I, Li H, et al. Phyllodes Tumour Network Singapore. Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histlogical criteria and surgical margins. J Clin Pathol 2012; 65: 69-76. 7. Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer 2000; 89: 1502-11. 23. Bucaloiu ID, Murphy T, Brown R, Siegelmann-Danieli N. Cystic-appearing pleural metastasis in a patient with recurrent phyllodes tumor. Breast J 2005; 11: 482. 9. Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001; 77: 428-35. 10. Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M, et al. Management of phyllodes breast tumors. Breast J 2011; 17: 129-37. 26. Allen R, Nixon D, York M, Coleman J. Successful chemotherapy for cystosarcoma phyllodes in a young woman. Arch Intern Med 1985; 145: 1127-8. 2. Pandey M, Mathew A, Kattoor J, Abraham EK, Mathew BS, Rajan B, et al. Malignant phyllodes tumor. Breast J 2001; 7: 411-6. 17. Barth RJ Jr. Histologic features predict local recurrence after breast conserving therapy of phyllodes tumors. Breast Cancer Res Treat 1999; 57: 291-5. 25. Hart WR, Bauer RC, Oberman HA. Cystosarcoma phyllodes. A clinicopathlogic study of twenty-six hypercellular periductal stromal tumors of the breast. Am J Clin Pathol 1978; 70: 211-6. 14. Kessinger A, Foley JF, Lemon HM, Miller DM. Metastatic cystosarcoma phyllodes: a case report and review of the literature. J Surg Oncol 1972; 4: 131-47. 16. Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, et al. Phyllodes tumours of the breast: a consensus review. Histopathology 2016; 68: 5-21. 15. Telli ML, Horst KC, Guardino AE, Dirbas FM, Carlson RW. Phyllodes tumors of the breast; natural history, diagnosis, and treatment. J Natl Compr Canc Netw 2007; 5: 324-30. 20. Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol 2005; 91: 185-94. 6. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumours of the breast. 4th ed. Lyon: IARC; 2012. 21. Hawkins RE, Schofield JB, Wiltshaw E, Fisher C, McKinna JA. Ifosfamide is an active drug for chemotherapy of metastatic cystosarcoma phyllodes. Cancer 1992; 69: 2271-5. 4. Powell CM, Rosen PP. Adipose differentiation in cystosarcoma phyllodes. A study of 14 cases. Am J Surg Pathol 1994; 18: 720-7. 5. Lee BJ, Pack GT. Giant intracanalicular myxoma of the breast: the so-called cystosarcoma phyllodes mammae of Johannes Muller. Ann Surg 1931; 93: 250-68. 18. Abdalla HM, Sakr MA. Predictive factors of local recurrence and survival following primary surgical treatment of phyllodes tumors of the breast. J Egypt Natl Canc Inst 2006; 18: 125-33. |
| References_xml | – reference: 2. Pandey M, Mathew A, Kattoor J, Abraham EK, Mathew BS, Rajan B, et al. Malignant phyllodes tumor. Breast J 2001; 7: 411-6. – reference: 22. Xiao M, Zhu Q, Jiang Y, Li J, Wang H, Zhang J, et al. Local recurrent phyllodes tumors of the breast: Clinical and sonographic features. J Ultrasound Med 2015; 34: 1631-8. – reference: 15. Telli ML, Horst KC, Guardino AE, Dirbas FM, Carlson RW. Phyllodes tumors of the breast; natural history, diagnosis, and treatment. J Natl Compr Canc Netw 2007; 5: 324-30. – reference: 26. Allen R, Nixon D, York M, Coleman J. Successful chemotherapy for cystosarcoma phyllodes in a young woman. Arch Intern Med 1985; 145: 1127-8. – reference: 6. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumours of the breast. 4th ed. Lyon: IARC; 2012. – reference: 18. Abdalla HM, Sakr MA. Predictive factors of local recurrence and survival following primary surgical treatment of phyllodes tumors of the breast. J Egypt Natl Canc Inst 2006; 18: 125-33. – reference: 13. Asoglu O, Ugurlu MM, Blanchard K, Grant CS, Reynolds C, Cha SS, et al. Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol 2004; 11: 1011-7. – reference: 14. Kessinger A, Foley JF, Lemon HM, Miller DM. Metastatic cystosarcoma phyllodes: a case report and review of the literature. J Surg Oncol 1972; 4: 131-47. – reference: 8. Reinfuss M, Mituś J, Duda K, Stelmach A, Ryś J, Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996; 77: 910-6. – reference: 16. Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, et al. Phyllodes tumours of the breast: a consensus review. Histopathology 2016; 68: 5-21. – reference: 12. Macdonald OK, Lee CM, Tward JD, Chappel CD, Gaffney DK. Malignant phyllodes tumor of the female breast: association of primary therapy with cause-specific survival from the surveillance, epidemiology, and end results (SEER) program. Cancer 2006; 107: 2127-33. – reference: 7. Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer 2000; 89: 1502-11. – reference: 19. Akcakaya A, Koc B, Erozgen F, Memmi N, Hot S, Yildiz MK, et al. Unpredictable behavior of breast phyllodes tumors. Eur Rev Med Pharmacol Sci 2014; 18: 2655-61. – reference: 17. Barth RJ Jr. Histologic features predict local recurrence after breast conserving therapy of phyllodes tumors. Breast Cancer Res Treat 1999; 57: 291-5. – reference: 1. Tan PH, Thike AA, Tan WJ, Thu MM, Busmanis I, Li H, et al. Phyllodes Tumour Network Singapore. Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histlogical criteria and surgical margins. J Clin Pathol 2012; 65: 69-76. – reference: 11. Grabowski J, Salzstein SL, Sadler GR, Blair SL. Malignant phyllodes tumors: a review of 752 cases. Am Surg 2007; 73: 967-9. – reference: 24. Ganti S, Svennevik E, Ali FS, Anikin V. Successful resection of giant solitary pulmonary metastasis from a phyllodes tumor. Ann Throac Surg 2007; 84: 1750-2. – reference: 5. Lee BJ, Pack GT. Giant intracanalicular myxoma of the breast: the so-called cystosarcoma phyllodes mammae of Johannes Muller. Ann Surg 1931; 93: 250-68. – reference: 20. Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol 2005; 91: 185-94. – reference: 4. Powell CM, Rosen PP. Adipose differentiation in cystosarcoma phyllodes. A study of 14 cases. Am J Surg Pathol 1994; 18: 720-7. – reference: 3. Tse GM, Niu Y, Shi HJ. Phyllodes tumor of the breast: an update. Breast Cancer 2010; 17: 29-34. – reference: 23. Bucaloiu ID, Murphy T, Brown R, Siegelmann-Danieli N. Cystic-appearing pleural metastasis in a patient with recurrent phyllodes tumor. Breast J 2005; 11: 482. – reference: 25. Hart WR, Bauer RC, Oberman HA. Cystosarcoma phyllodes. A clinicopathlogic study of twenty-six hypercellular periductal stromal tumors of the breast. Am J Clin Pathol 1978; 70: 211-6. – reference: 9. Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001; 77: 428-35. – reference: 21. Hawkins RE, Schofield JB, Wiltshaw E, Fisher C, McKinna JA. Ifosfamide is an active drug for chemotherapy of metastatic cystosarcoma phyllodes. Cancer 1992; 69: 2271-5. – reference: 10. Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M, et al. Management of phyllodes breast tumors. Breast J 2011; 17: 129-37. |
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| Snippet | 症例は54歳女性．他院で左乳腺葉状腫瘍に対して手術施行後，経過観察され，再発を指摘されていなかった．乳腺腫瘍術後6年目に咳嗽，胸部圧迫感を認めた．胸部CT上，左肺上葉中枢側を主座に内部不均一な長径16... |
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| SubjectTerms | 乳腺葉状腫瘍 肺切除 肺転移 |
| Title | 乳腺葉状腫瘍切除後6年目に発症した孤立性肺転移の1切除例 |
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