腋窩リンパ節転移を初発とした乳癌の1例

Abstract

A 63-year-old woman who had noticed a right axillary mass was seen at the hospital in January, 1993. On cytology she was suspected of having a malignancy and underwent right axillary lymph nodes dissection. Pathologically it was metastatic adenocarcinoma. Mammoechography, Ga scan, Ba enema or meal and abdominal CT were done to search for an origin, but the origin Was unknown. Metastasis in the supraclavicular lymph nodes was found in July, and then cleaning of lymph nodes of the neck and irradiation therapy were performed. Another mass was found near the operative scar on right axilla in January 1994, and pathological examination of the resected mass showed lymph node metastasis of invasive ductal carcinoma. Three months later, a mass in D area of the right breaSt was palpated and Auchincloss method was carried out. Pathologically it was medullary carcinoma. Clinicopathologically this case was thought to be occult breast carcinoma presenting as axillary lymph node metastasis. CEF therapy, and medication with Tamoxifen and 5' DFUR were added postoperatively. The patient died because of local recurrence of the right breast and lung metastasis in July 1996.