A case of adenoid cystic carcinoma of the breast with the invasion to the skin

乳腺腺様嚢胞癌は乳癌全体の約0.1%と稀であり,リンパ節転移や遠隔転移は非常に少なく,予後は局所治療のみで良好である.今回,皮膚浸潤を伴う局所進展が高度な乳腺腺様嚢胞癌の1例を経験したので報告する.症例は58歳,女性.左乳房C領域に圧痛を伴う7×5cmの腫瘤を触知して当院を受診した.皮膚の発赤を認め,腫瘍は皮膚に固定されていた.マンモグラフィでカテゴリー4,超音波検査では辺縁不整,境界不明瞭,内部エコー不均一な腫瘤を認めた.針生検を行い,腺様嚢胞癌が疑われた.胸筋温存乳房切除術,LevelⅠ腋窩リンパ節郭清を行った.ホルモン受容体はER(-),PgR(-),HER2(-)であり,リンパ節転移は認めなかった.術後は補助療法を行わず経過観察のみを行い,7年経過したが,再発･転移は認めていない.本疾患は局所進展の程度に関わらず,局所治療が適切に行われれば良好な予後が期待できると考えられた.

Adenoid cystic carcinoma(ACC)is a rare type of breast cancer that represents about 0.1% of all breast cancers, and considered as a good prognostic disease with rare instances of local recurrence or distant metastasis. We report a rare case of adenoid cystic carcinoma of the breast with the widely growth and the invasion to the skin. A 58-year-old woman visited our hospital because of a palpable tumor about 7cm in diameter with tenderness and skin redness in the C area of the left breast. A mammogram showed a lobulated mass with unclear border and resulted in category 4. An ultrasonogram showed a low-echoic tumor with partially unclear border and heterogeneous inner part. With core-needle biopsy, we suspected the histologic type of this tumor was ACC. Modified mastectomy with levelⅠaxillary lymph node dissection was performed. There was no lymph node metastasis or distant metastasis. Estrogen and progesterone receptors were negative, and no HER-2 expression in this tumor. She has been free from recurrence for 7 years after the operation. Thus we consider that once a complete excision of the local lesion is carried out, the prognosis is good, regardless of the progression or the invasion.

乳癌

腺様嚢胞癌

皮膚浸潤