Primary Osteosarcoma of the Breast: A Case Report in Taiwan

乳房原發性骨肉瘤是一個少見的骨骼外骨肉瘤。回顧過去的文獻多為病例報告，且多數引用1998年由Silver及Tavassoli發表的追蹤38年有50個病例數的研究。這類腫瘤發生原因不明，但可能出現在放射治療後、外傷後或乳房植入外來異物後，且無特定好發年齡。這類腫瘤為高惡性度預後不佳，且易轉移的腫瘤，多為血液擴散，少見淋巴擴散，常見轉移部位是肺部。治療方式仍以手術切除為主，對於腫瘤轉移的病患，才考慮化學治療。我們在此報告一例乳房原發性骨肉瘤，接受左側改良式全乳房切除手術，病理切片發現基部邊緣仍殘留腫瘤，因此給予術後放射線治療及化學治療，雖然未發生局部復發的情況，但在術後十五個月仍然發生肺部轉移。大部分的病例報告較少談論到放射治療，就此病例而言，放射治療可能降低疾病的局部復發率，但無法改善骨肉瘤的高轉移率。

關鍵字

乳房原發性骨肉瘤；乳房；放射治療

並列摘要

Primary breast osteosarcoma is an aggressive and relatively rare tumour with poor prognosis. It is associated with early recurrence and hematogenous rather than lymphatic spread, most commonly to the lungs. We report a case in a 32-year-old woman who presented with a hard painless lump at left breast of six years duration. Left side nipple sparing mastectomy including axillary lymph node dissection was carried out. The tumor was 10 x 9.5 x 6 cm in size. Histopathology of the nipple sparing mastectomy specimen showed predominantly osteosarcomatous areas. Immunohistochemistry indicated that neoplastic osteoblastic cells of the tumor stained positively for vimentin, but negatively for epithelial markers; which suggested. Immunohistochemistry plays a pivotal role in the diagnosis of this type of tumor. Because there was no evidence of metastasis and residual tumoral cell was present at the base of site of surgery, she received adjuvant radiotherapy and chemotherapy. But she remained disease free at 15 months at which time metastases of bone and lung were diagnosed.

並列關鍵字

Osteosarcoma ； Breast ； Radiotherapy

國際替代計量

Primary Osteosarcoma of the Breast: A Case Report in Taiwan

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