原发性乳腺鳞状细胞癌1例并文献回顾

Primary Squamous Cell Carcinoma of the Breast: A Case Report and Literature Review

目的:探讨乳腺化生性鳞状细胞癌的临床特征、诊断和治疗。方法:通过分享1例乳腺化生性鳞状细胞癌的临床、病理资料及诊治过程,查阅和回顾相关文献,讨论乳腺化生性癌的诊治方法和思路。结果:患者术后病理:(右侧)根治切除乳腺标本外上象限见化生性癌–鳞状细胞癌(组织学II级,镜下浸润范围3.1 × 1.4 cm),见导管原位癌(中级别,筛孔型,约占70%),区域淋巴结:右侧腋窝淋巴结内见癌转移(1/14)。病理学分期:ypT2N1aMx。免疫组化结果:ER(−),PR(−),HER2(2+),Ki-67(+,约30%),CK5/6(+),CK14(−),P53(弱+),E-Cadherin(+),P120Catenin(膜+),EGFR(+),D2-40示脉管癌栓(+)。结论:病理检查及免疫组化分析对于明确乳腺化生性鳞状细胞癌的诊断至关重要,以根治性手术为主结合化疗的综合治疗是目前最合理治疗方法。

Objective: To investigate the clinical features, diagnosis and treatment of mammary hyperplastic squamous cell carcinoma. Methods: By sharing the clinical and pathological data and the diagnosis and treatment process of a case of mammary hyperplastic squamous cell carcinoma, the relevant literature was reviewed to discuss the diagnosis and treatment methods and ideas of mammary hyperplastic carcinoma. Results: The postoperative pathology of the patient was as follows: (right) radical resection of the breast specimen showed chemoplastic carcinoma-squamous cell carcinoma (histological grade II, scope of infiltration 3.1 × 1.4 cm) in the upper outer quadrant, ductal carci-noma in situ (medium grade, ethmoid type, accounting for about 70%), regional lymph nodes: can-cer metastasis was found in the right axillary lymph node (1/14). Pathological stage: ypT2N1aMx. Immunohistochemical results: ER(−), PR(−), HER2(2+), Ki-67(+, about 30%), CK5/6(+), CK14(−), P53(weak +), E-Cadherin(+), P120Catenin(membrane +), EGFR(+), D2-40 indicating vascular cancer thrombolus(+). Conclusion: Pathological examination and immunohistochemical analysis are very important for the diagnosis of mammary hyperplastic squamous cell carcinoma. Radical surgery combined with chemotherapy is the most reasonable treatment at present.