男性隐匿性乳腺癌甲状腺转移1例并文献复习  

A Case of Male Occult Breast Cancer with Thyroid Metastases and Literature Review

作　　者：刘方丽 张少华 LIU Fangli;ZHANG Shaohua(Department of Oncology,Mudan People´s Hospital,Heze,Shandong Province,274000 China)

机构地区：[1]菏泽市牡丹人民医院肿瘤科,山东菏泽274000

出　　处：《系统医学》2023年第8期165-168,共4页Systems Medicine

摘　　要：目的男性隐匿性乳腺癌(male occult breast cancer,MOBC)在临床上罕见,发病率远低于女性乳腺癌,占全部乳腺癌患者的0.5%~1%。对本病认识不足常导致延误诊治,因此需重视MOBC的临床病理特征、治疗策略及生存情况。方法本文报道2022年7月菏泽市牡丹人民医院收治的1例57岁MOBC。回顾性分析该患者的诊断及治疗过程和生存情况,并复习相关文献,供临床医师参考。结果患者57岁,临床上表现为右颈部肿块,行双侧甲状腺肿瘤切除术,术后病理为乳腺浸润性癌(TxN3M1Ⅳ期,HR阴性HER-2阳性),术后进展制订方案“曲妥珠单抗+帕妥珠单抗+紫杉醇脂质体”6周期,HP维持,4周期评估大PR。结论MBC病因尚未明确,迄今尚无标准的筛查指南。MBC与乳腺癌家族史、BRCA2基因突变及体内雌激素失衡等因素密切相关,检查方法首选超声检查及钼靶检查,对高度可疑癌变的肿瘤应尽早行穿刺活检明确诊断,病理类型多为浸润性导管癌。早发现治疗预后较好,对于MBC治疗依据女性乳癌治疗方案,以手术、放化疗、靶向、内分泌等多种手段在治疗中综合应用。Objective Male occult breast cancer(MOBC)is clinically rare,and its incidence is much lower than female breast cancer,accounting for 0.5%-1%of all breast cancer patients.Insufficient understanding of this disease often leads to delayed diagnosis and treatment,so it is necessary to pay attention to the clinicopathological features,treatment strategies and survival of MOBC.Methods The paper reported a 57-year-old MOBC case admitted to Mudan People´s Hospital of Heze City in July 2022.The diagnosis,treatment process and survival of the patient were retrospectively analyzed,and relevant literature was reviewed for reference by clinicians.Results A 57-year-old patient presented clinically with a right neck mass and underwent bilateral thyroid tumor resection.The postoperative pathology was breast invasive carcinoma(TxN3M1 stage IV HR negative HER-2 positive).After the postoperative progress,a plan of"trastuzumab+pertuzumab+paclitaxel liposome"was formulated for 6 cycles,HP was maintained,and a large PR was evaluated for 4 cycles.Conclusion The etiology of MBC has not been clarified,and there is no standard screening guideline so far.MBC is closely related to factors such as family history of breast cancer,BRCA2 gene mutation,and estrogen imbalance in the body.Ultrasonography and mammography are the preferred examination methods.For highly suspicious tumors,biopsy should be performed as soon as possible to confirm the diagnosis.The pathological type is mostly invasive ducts cancer.Early detection and treatment have a better prognosis.For MBC,the treatment is based on the treatment plan for female breast cancer,and multiple methods such as surgery,radiotherapy and chemotherapy,targeting,and endocrine are used comprehensively in the treatment.

关 键 词：男性乳腺癌 隐匿性乳腺癌 个案报道 

分 类 号：R73[医药卫生—肿瘤]