乳腺癌合并甲状腺乳头状癌临床病理分析并文献复习

Clinicopathologic analysis and literature review of breast carcinoma complicated with thyroid papillary carcinoma

目的探讨乳腺癌(Breast carcinoma,BC)合并甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)的临床病理特征。方法回顾性分析2018年9月—2023年1月于东莞东华医院及东莞松山湖东华医院确诊为BC合并PTC的12例患者的临床及病理资料。结果病例全部为女性,年龄26~55岁,中位年龄46.5岁,平均年龄46.1岁,4例已绝经,8例未绝经,10例为体检时同时发现乳腺及甲状腺有肿物,术后病理证实为BC及PTC,其中2例不是同时发现BC及PTC。乳腺癌组织学类型:11例为非特殊型浸润性乳腺癌(Invasive breast carcinoma of no special type,IBC-NST),1例为导管原位癌(Ductal carcinoma in situ,DCIS)合并交界性叶状肿瘤(Boderline phyllodes tumor,BPT)。乳腺癌分子分型:6例为Luminal B型,2例为Luminal A型,3例为三阴型,1例为导管原位癌,无需分型。乳腺癌组织学分级:1例1级,6例2级,4例3级。5例BC先行新辅助治疗后再切乳腺,7例未行新辅助治疗直接切乳腺。3例甲状腺功能异常,9例无异常。6例甲状腺乳头状癌为单发,最大径6~15 mm,余6例≥2个癌灶,最大径1~44 mm。7例PTC伴颈部淋巴结转移,5例无转移。结论BC合并PTC比较罕见,具有独特的临床病理特征,探讨其发生的机制对临床的诊治具有一定的指导意义。

Objective To investigate the clinicopathological characteristics of breast carcinoma(BC)complicated with papillary thyroid carcinoma(PTC).Methods The clinical and pathological data of 12 patients diagnosed with BC complicated with PTC in Dongguan Tungwah Hospital and Dongguan Songshan Lake Tungwah Hospital from September 2018 to January 2023 were retrospectively analyzed.Results All cases were female,aged 26-55 years old,median age 46.5 years old,mean age 46.1 years old;Four cases were postmenopausal,eight cases were not postmenopausal;Breast and thyroid masses were found ten patients during physical examination,postoperative pathology confirmed to be BC and PTC,two cases were not found BC and PTC at the same time.Eleven cases were invasive breast carcinoma of no special type(IBC-NST),one case was ductal carcinoma in situ(DCIS)complicated with boderline phyllodes tumor(BPT).Six cases were Luminal B,two cases were Luminal A,three cases were triple negative type,and one case was DCIS of no typing required.As for histological grading of breast cancer:one case was grading 1,six cases were grading 2,four cases were grading 3.Five patients underwent breast resection after neoadjuvant therapy,and other seven patients underwent breast resection direct.Three cases had abnormal thyroid function and other nine were normal.Six cases of PTC were single nodular,with a maximum diameter of 6 to 15mm,and the remaining six cases had more than two nodulars,with a maximum diameter of 1~44 mm.Seven cases of PTC had cervical lymph node metastasis and five cases had no metastasis.Conclusions BC complicated with PTC is rare and has unique clinicopathological features.It is of guiding significance for clinical diagnosis and treatment to investigate the mechanism of its occurrence.