隐匿性乳腺大汗腺癌伴腋下鳞癌化生1例并文献复习

Occult Apocrine Carcinomas Accompanied of 1 Case of Breast with Axillary Metaplasia Squamous Cell Carcinoma and Literature Review

目的:探讨隐匿性乳腺大汗腺癌伴腋下鳞癌化生的临床病理学特征及诊断、治疗和预后。方法:回顾分析解放军第二炮兵总医院2012年4月收治的1例隐匿性乳腺大汗腺癌伴腋下鳞癌化生手术加辅助化疗治疗患者,运用组织病理学及免疫组化观察其特点,复习国内外相关文献进行分析。结果:患者行两次新辅助化疗后行右乳改良根治术加腋下淋巴结清扫,术后病理提示:乳腺大汗腺癌,腋下转移性高中分化鳞癌。术后随访3个月,患者仍健在。结论:隐匿性乳腺癌发病率较低,而病理类型为大汗腺癌伴腋下鳞癌化生的更少见,新辅助化疗效果不明显,治疗仍以外科手术为主,辅助以全身化疗及局部放疗。

Objective: To investigate clinical pathological features,diagnosis,treatment and prognosis of occult apocrine carcinoma of breast with axillary metaplastic squamous cell carcinoma.Methods: The surgical and adjuvant chemotherapy treatment of one patient with occult apocrine carcinomas of the breast accompanied with axillary metaplastic squamous cell carcinoma in our hospital in April 2012 was retrospectively analyzed.Histopathological and immunohistochemical characteristics of the carcinoma and related literature review at home and abroad were analyzed and summarized.Results: The patient underwent adjuvant chemotherapy twice and then under through right modified radical mastectomy plus the axillary dissection.The postoperation pathological examination indicated apocrine carcinomas of the right breast carcinoma and axillary metaplastic squamous cell carcinoma.The patient was followed up for three months and is still alive.Conclusions: Occult apocrine carcinoma of the breast has little incidence rate.And the pathological type as apocrine carcinoma combined with axillary metaplastic squamous cell carcinoma is rarer.Adjuvant chemotherapy is ineffective;the major treatment is surgical combined with chemotherapy and local radiotherapy.