乳房温存術後にPaget病を発症した1例
今回われわれは乳房温存術後にPaget病をきたした症例を経験したので報告する．症例は64歳，女性．他院で乳癌と診断され（TisN0M0 pStage 0）左乳房部分切除術+センチネルリンパ節生検が施行された．術後に温存乳房に対し放射線照射が行われた．術後1年半より患側乳頭部にびらんが出現し，皮膚炎として経過観察されていた．術後5年になりびらんの範囲が拡大し皮膚生検を施行したところ，Paget病と診断され当院を紹介受診した．乳房温存手術後のPaget病型再発と診断し左乳房切除術を施行した．このようなPaget病の発症は比較的まれであるが長期にわたり経過観察されることが多く常に念頭におく必要がある...
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| Published in | 日本臨床外科学会雑誌 Vol. 73; no. 4; pp. 774 - 779 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床外科学会
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-2843 1882-5133 |
| DOI | 10.3919/jjsa.73.774 |
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| Abstract | 今回われわれは乳房温存術後にPaget病をきたした症例を経験したので報告する．症例は64歳，女性．他院で乳癌と診断され（TisN0M0 pStage 0）左乳房部分切除術+センチネルリンパ節生検が施行された．術後に温存乳房に対し放射線照射が行われた．術後1年半より患側乳頭部にびらんが出現し，皮膚炎として経過観察されていた．術後5年になりびらんの範囲が拡大し皮膚生検を施行したところ，Paget病と診断され当院を紹介受診した．乳房温存手術後のPaget病型再発と診断し左乳房切除術を施行した．このようなPaget病の発症は比較的まれであるが長期にわたり経過観察されることが多く常に念頭におく必要がある． |
|---|---|
| AbstractList | 今回われわれは乳房温存術後にPaget病をきたした症例を経験したので報告する．症例は64歳，女性．他院で乳癌と診断され（TisN0M0 pStage 0）左乳房部分切除術+センチネルリンパ節生検が施行された．術後に温存乳房に対し放射線照射が行われた．術後1年半より患側乳頭部にびらんが出現し，皮膚炎として経過観察されていた．術後5年になりびらんの範囲が拡大し皮膚生検を施行したところ，Paget病と診断され当院を紹介受診した．乳房温存手術後のPaget病型再発と診断し左乳房切除術を施行した．このようなPaget病の発症は比較的まれであるが長期にわたり経過観察されることが多く常に念頭におく必要がある． |
| Author | 山本, 尚人 杉山, 孝弘 渡邉, 善寛 宮崎, 勝 尾内, 康英 中村, 力也 |
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| References | 18) NCCN Clinical Practice Guidelines in Oncology, Breast cancer v.2.2011, (Accessed Jan 30, 2011, at http://www.nccn.org/professionals/physician_gls/PD/breast.pdf 7) Laronga C, Kemp B, Jhonston D, et al : The incidence of occult nipple-areola complex involvement in breast cancer patients receiving a skin-sparing mastectomy. Ann Surg Oncol 1999 ; 6 : 609-613 15) Sukumvanich P, Bentrem DJ, Cody HS, et al : The role of sentinel lymph node biopsy in Paget's disease of the breast. Ann Surg Oncol 2007 ; 14 : 1020-1023 6) Komoike Y, Akiyama F, Ikeda T, et al : Analysis of Ipsilateral Breast Tumor Recurrences after Breast-conserving Treatment Based on The Classification of True Recurrences and New Primary Tumors. Breast Cancer 2005 ; 12 : 104-111 8) Luttges J, Kalbfleisch H, Prinz P : Nipple involvement and multicentricity in breast cancer : A study on whole organ sections. J Cancer Res Clin Oncol 1987 ; 113 : 481-487 2) Rosen PP : Paget Disease of the Nipple. Rosen's Breast Pathology third edition, Lippincott Williams & Wilkins, Philadelphia, 2009, p621-636 11) Ashikari R, Park K, Huvos AG, et al : Paget's disease of the breast. Cancer 1970 ; 26 : 680-685 16) Port ER, Garcia-Etienne CA, Park J : Reoperative Sentinel Lymph Node Biopsy : A new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol 2007 ; 14 : 2209-2214 14) Menzies D, Barr L, Ellis H : Paget's disease of the nipple occurring after wide local excision and radiotherapy for carcinoma of the breast. Eur J Surg Oncol 1989 ; 15 : 271-273 10) Chaudary MA, Millis RR, Lane EB, et al : Paget's disease of the nipple : A ten-year review including clinical, pathological and immunohistochemical findings. Breast Cancer Res Treat 1986 ; 8 : 139-146 13) Kollmorgen DR, Varanasi JS, Edge SB, et al : Paget's disease of the breast : A 33-year experience. J Am Coll Surg 1998 ; 187 : 171-177 9) Chen C, Sun L, Anderson B : Paget Disease of the Breast : Changing Patterns of Incidence, Clinical Presentation, and Treatment in the U.S. Cancer 2006 ; 107 : 1448-1458 3) Caliskan M, Gatti G, Sosnovskikh I, et al : Paget's disease of the breast : the experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat 2008 ; 112 : 513-521 17) Intra M, Trifiro G, Galimberti V : Socond axillary sentinel lymph node biopsy for ipsilateral breast tumor recurrence. Br J Surg 2007 ; 94 : 1216-1219 5) Huang E, Buchholz TA, Meric F, et al : Classifying local disease recurrences after breast conservation therapy based on location and histology : new primary tumors have more favorable outcomes than true local disease recurrences. Cancer 2002 ; 95 : 2059-2067 4) Solin LJ, Fourquet A, Vicini FA, et al : Long-term outcome after Breast-conservation Treatment with radiation for mammmographically detected ductal carcinoma in situ of the breast. Cancer 2005 ; 103 : 1137-1146 1) Kothari AS, Beechey-Newman N, Hamed H, et al : Paget Disease of the Nipple : a multifocal manifestation of higher-risk disease. Cancer 2002 ; 95 : 1-7 12) Kister SJ, Haagenson CD : Paget's disease of the breast. Am J Surg 1970 ; 119 : 606-609 |
| References_xml | – reference: 8) Luttges J, Kalbfleisch H, Prinz P : Nipple involvement and multicentricity in breast cancer : A study on whole organ sections. J Cancer Res Clin Oncol 1987 ; 113 : 481-487 – reference: 16) Port ER, Garcia-Etienne CA, Park J : Reoperative Sentinel Lymph Node Biopsy : A new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol 2007 ; 14 : 2209-2214 – reference: 15) Sukumvanich P, Bentrem DJ, Cody HS, et al : The role of sentinel lymph node biopsy in Paget's disease of the breast. Ann Surg Oncol 2007 ; 14 : 1020-1023 – reference: 5) Huang E, Buchholz TA, Meric F, et al : Classifying local disease recurrences after breast conservation therapy based on location and histology : new primary tumors have more favorable outcomes than true local disease recurrences. Cancer 2002 ; 95 : 2059-2067 – reference: 14) Menzies D, Barr L, Ellis H : Paget's disease of the nipple occurring after wide local excision and radiotherapy for carcinoma of the breast. Eur J Surg Oncol 1989 ; 15 : 271-273 – reference: 11) Ashikari R, Park K, Huvos AG, et al : Paget's disease of the breast. Cancer 1970 ; 26 : 680-685 – reference: 17) Intra M, Trifiro G, Galimberti V : Socond axillary sentinel lymph node biopsy for ipsilateral breast tumor recurrence. Br J Surg 2007 ; 94 : 1216-1219 – reference: 7) Laronga C, Kemp B, Jhonston D, et al : The incidence of occult nipple-areola complex involvement in breast cancer patients receiving a skin-sparing mastectomy. Ann Surg Oncol 1999 ; 6 : 609-613 – reference: 10) Chaudary MA, Millis RR, Lane EB, et al : Paget's disease of the nipple : A ten-year review including clinical, pathological and immunohistochemical findings. Breast Cancer Res Treat 1986 ; 8 : 139-146 – reference: 1) Kothari AS, Beechey-Newman N, Hamed H, et al : Paget Disease of the Nipple : a multifocal manifestation of higher-risk disease. Cancer 2002 ; 95 : 1-7 – reference: 9) Chen C, Sun L, Anderson B : Paget Disease of the Breast : Changing Patterns of Incidence, Clinical Presentation, and Treatment in the U.S. Cancer 2006 ; 107 : 1448-1458 – reference: 3) Caliskan M, Gatti G, Sosnovskikh I, et al : Paget's disease of the breast : the experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat 2008 ; 112 : 513-521 – reference: 12) Kister SJ, Haagenson CD : Paget's disease of the breast. Am J Surg 1970 ; 119 : 606-609 – reference: 18) NCCN Clinical Practice Guidelines in Oncology, Breast cancer v.2.2011, (Accessed Jan 30, 2011, at http://www.nccn.org/professionals/physician_gls/PD/breast.pdf) – reference: 6) Komoike Y, Akiyama F, Ikeda T, et al : Analysis of Ipsilateral Breast Tumor Recurrences after Breast-conserving Treatment Based on The Classification of True Recurrences and New Primary Tumors. Breast Cancer 2005 ; 12 : 104-111 – reference: 13) Kollmorgen DR, Varanasi JS, Edge SB, et al : Paget's disease of the breast : A 33-year experience. J Am Coll Surg 1998 ; 187 : 171-177 – reference: 2) Rosen PP : Paget Disease of the Nipple. Rosen's Breast Pathology third edition, Lippincott Williams & Wilkins, Philadelphia, 2009, p621-636 – reference: 4) Solin LJ, Fourquet A, Vicini FA, et al : Long-term outcome after Breast-conservation Treatment with radiation for mammmographically detected ductal carcinoma in situ of the breast. Cancer 2005 ; 103 : 1137-1146 |
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| Snippet | 今回われわれは乳房温存術後にPaget病をきたした症例を経験したので報告する．症例は64歳，女性．他院で乳癌と診断され（TisN0M0 pStage 0）左乳房部分切除... |
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| SubjectTerms | Paget病 センチネルリンパ節生検 乳房内再発 |
| Title | 乳房温存術後にPaget病を発症した1例 |
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