淺談骨轉(zhuǎn)移性乳腺癌

淺談骨轉(zhuǎn)移性乳腺癌第1頁/共23頁GeneralinformationName:WUChunHongAge:40ySex:FemaleDateofadmission:February9th,2011Dateofdischarge:April23th,2011第2頁/共23頁ChiefcomplaintShegothypoesthesiaoflowerlimbsandinabilitytowalkformorethanamonth第3頁/共23頁HistoryofpresentillnessThepatientfelt

painonthebackbynoobviousincentivesinJune2010Thepainwastingling,especiallyinnight-timeThepatienttookorallytraditionalChinesemedicine,buthadnottangibleeffects第4頁/共23頁P(yáng)ast,

Personal&FamilyHistoryNo

hepatitis,hypertension,ordiabetesNosmoking,alcoholordrugabuseNoinheriteddiseasesNohistoryofdrugallergyNormalmenstruation第5頁/共23頁ClinicalfindingsTheleftbreastpresentedwithdiffusederythemaandedema,

indurationaboutsizeof3.0cm*3.0cm第6頁/共23頁Ultrasoundexaminationa3cmleftbreastmassandanormalrightbreast第7頁/共23頁ThoracicMRIexamination

第8頁/共23頁ThoracicMRIexaminationHigh-densitymasswasshownonthesevenththoracic,andbonedestructionalsohadbeenfound.EnhancedMRI第9頁/共23頁Laboratoryexamination2011-02-091.HepaticfunctionsALT40U/LAST20U/LTBNormal3.TumormarkersCA19-9Normal2.Bloodroutinetest

Hb82g/L

RBC4.54×1012/L

WBC6.1×109/LPLT201×109/L第10頁/共23頁puncturebiopsyShereceivedultrasoundguidedbreastcoreneedlepuncturebiopsyPuncturetissuepathology:Theleftbreastinvasiveductalcarcinoma第11頁/共23頁P(yáng)rimarydiagnosis

Breastcancerwithbonemetastasis第12頁/共23頁TreatmentOnFebruary11,2011inorthopedicdepartment,ThePatientreceived"thesevenththoracictumorresectionandpediclescrewfixation"第13頁/共23頁HistologicalexaminationSevenththoracictumorswasidentifiedasmetastaticcarcinoma,andtheimmunohistochemistryresultsshowedthepossibilityofbreastcancerbonemetastasiswasverylarge第14頁/共23頁IMMUNOHISTOCHEMICALresultsER++PR++CerbB2-

CK20-EMA++,Ckpan+++,CK5/6-第15頁/共23頁TreatmentThepatientrecoveredwell,andthentransferredintoourdepartmentChemotherapytwotimesbeforeoperation:February23,2011March20,2011ThechemotherapyplanwasTEC第16頁/共23頁TreatmentAfterthe

chemotherapyThelesionsareaofleftbreastshowednoreduction第17頁/共23頁TreatmentModifiedradicalmastectomyonmarch31,2011BilateraloophorectomyOnthesameday第18頁/共23頁HistologicalexaminationTheleftbreastinvasiveductalcarcinomaThebasalresectionmarginoftumorwasclosetothesurroundingnormaltissueTheaxillarylymphnodesmetastasis(13/15)第19頁/共23頁ImmunohistochemicalER++PR++CerbB2-

E-cad+++,Ki6750%+,P53+,Ck5/6-第20頁/共23頁Trea