A Case of Disseminated Myelocarcinoma with Bone Metastasis 15 Years after Mastectomy and Relatively Long-Term Survival through Multidisciplinary Treatment

The patient was a 62-year-old woman who had undergone mastectomy in August 2003 for cancer of the right breast. In addition to radiation therapy in the remaining breast, chemotherapy and endocrine therapy were subsequently performed. The patient had a 10-year recurrence-free postoperative course fol...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 48; no. 13; p. 1592
Main Authors Aoyagi, Haruhiko, Higuchi, Katsuyoshi, Matsunaga, Hiroko, Koseki, Keita, Watanabe, Ichiro, Nishi, Naoto, Nihei, Zenro, Itoh, Masashi, Sakamoto, Haruko
Format Journal Article
LanguageJapanese
Published Japan 01.12.2021
Subjects
Bone Neoplasms - therapy
Breast Neoplasms - drug therapy
Breast Neoplasms - surgery
Female
Humans
Mastectomy
Middle Aged
Neoplasm Recurrence, Local
Positron Emission Tomography Computed Tomography
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Summary:The patient was a 62-year-old woman who had undergone mastectomy in August 2003 for cancer of the right breast. In addition to radiation therapy in the remaining breast, chemotherapy and endocrine therapy were subsequently performed. The patient had a 10-year recurrence-free postoperative course followed by annual surveillance. Beginning in 2016, an elevation in the serum level of tumor markers was detected; however, no accumulations were found in PET-CT over 2 consecutive years(2016 and 2017). Thereafter, serum levels of tumor markers continued to rise, and a PET-CT in 2018 revealed costal accumulations leading to a diagnosis of late-stage bone metastasis in postoperative year 15. Although hormone therapy was resumed, a continuing rise in the serum level of tumor markers led to a diagnosis of diffuse bone metastasis by MRI in 2019. Treatment with abemaciclib was initiated, and with effective radiotherapy, the PS was maintained at 0-1, serum levels of tumor markers decreased, and the lesions themselves continued at SD. However, in June 2020, multiple liver metastases appeared in an abdominothoracic CT scan. The patient refused chemotherapy; this, a BSC policy was adopted. Acute hemolytic anemia occurred immediately thereafter, and the PS gradually deteriorated. The patient died in September 2020, 17 years and 1 month after surgery.
ISSN:0385-0684