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Clinicopathological Study of Epithelial Metaplastic Breast Cancer

Journal of Cancer Therapy 2016年第13期7卷 1039-1044页

作者： Masahiro Kitada Shunsuke Yasuda nana takahashi Satoshi Okazaki Kei Ishibashi Satoshi Hayashi Department of Breast Disease Center Asahikawa Medical University Asahikawa Japan

Introduction: Metaplastic breast cancer (MBC) is a rare pathological type with an incidence rate of not more than 1%, and has been reported to be often detected after its progression and highly malignant with a high proportion of triple negative type tumors, with poor outcomes as compared to IDC [1] [2] [3]. We analyzed clinicopathological characteristics of patients who underwent surgery for epithelial MBC at our department. Patients and Methods: From January 2000 to March 2014, a total of 2120 patients underwent surgery for breast cancer, and MBC was diagnosed in 15 of these patients. Fourteen of the 15 had epithelial MBC and were included in this study. The present study compared clinopathological characteristics of MBC with those of IDC of triple negative type (TN type group) and IDC of non-triple negative type (IDC group). Results: Breast conserving surgery was performed in 7 patients with MBC (50%), a proportion clearly lower than the 64.3% in the IDC group. The mean tumor size was 3.8 cm, which was greater than the 2.13 cm in the TN type group and the 1.7 cm in the IDC group. About nuclear grade, the proportion of grade III was 57.1%, markedly higher than the 38.6% in the TN type group and the 12.6% in the IDC group. All patients were estrogen receptor (ER) and progesterone receptor (PgR) negative;11 patients were TN type tumors and 3 were HER2 type. Conclusion: We studied patients who underwent surgery for epithelial MBC. The examined cases showed clinopathological characteristics of the disease, including large tumors with a highly malignant nature at the initial detection, higher Ki-67 levels, ER and PgR negativity (all cases), mostly TN type, and a high recurrence rate.

关键词： Breast Cancer Metaplastic Breast Cancer Triple Negative Type Epithelial-Mesenchymal Transition

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Intramedullary Spinal Cord Metastases in Breast Cancer: Report a Case

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Journal of Cancer Therapy 2016年第13期7卷 1034-1038页

作者： Masahiro Kitada nana takahashi Shunsuke Yasuda Satoshi Okazaki Kei Ishibashi Satoshi Hayashi Department of Breast Disease Center Asahikawa Medical University Asahikawa Japan

Background: Intramedullary spinal cord metastasis (ISCM) from breast cancer is a relatively rare disease. We present this disease. Case presentation: The patient was a 67-year-old woman with lung metastasis appearing 3 years after breast cancer surgery. Complete remission was achieved for the metastatic lesion with chemotherapy, but multiple cerebellar metastases were found 3 months after the completion of chemotherapy. Whole-brain irradiation was administered, resulting in symptomatic improvement. Approximately 6 months later, the patient experienced weakness in the lower extremities and difficulty walking. Magnetic resonance imaging detected a well-defined intraspinal tumor measuring 13 × 13 × 30 mm at the level of Th12-L1. After 20-Gy irradiation to the tumor, oral steroid administration, and rehabilitation, the patient regained the ability to walk. Eight months have passed, to date, since these interventions and the patient is currently receiving treatment for metastases to bones, including the spine, but is still capable of walking without difficulty. We herein report this case with a review of the relevant literature. Conclusion: ISCM in the breast cancer is relatively rare. But, it is the clinical condition which it should always place in the mind.

关键词： Breast Cancer Intramedullary Spinal Cord Metastasis (Iscm) Brain Metastasis

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Surgical Treatment of Idiopathic Multiple Pulmonary Arteriovenous Malformation Identified at the Onset of Cerebral Infarction: A Case Report

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Open Journal of Respiratory Diseases 2017年第2期7卷 62-67页

作者： Masahiro Kitada Shunsuke Yasuda nana takahashi Satoshi Okazaki Kei Ishibashi Satoshi Hayashi Yoshinobu Ohsaki Department of Respiratory Center Asahikawa Medical University Hokkaido Japan

Pulmonary arteriovenous malformation (PAVM), which is asymptomatic in most cases, is often identified in patients with central nervous system disorders such as brain abscesses and/or cerebral infarctions. We have reported a patient with idiopathic multiple PAVM identified at the onset of cerebral infarction. A 69-year-old woman visited the Department of Neuropathic Internal Medicine at our hospital with chief complaints of numbness in her left hand and a feeling of weakness. The patient was given a diagnosis of subacute cerebral infarction. Multiple old lacunar infarctions were also observed in the deep white matter of the left frontal lobe. Chest computed tomography showed multiple nodular structures, mainly in the right lower lung field (S8), as well as continuous arteries and veins at the site;thus, the patient was finally diagnosed with multiple PAVM. Right lower thoracoscopic lobectomy was performed, as is typical surgical practice in such cases. The patient had a favorable postoperative course, and had no recurrence of cerebral infarction. Although the patient’s lesions were mainly restricted to S8, the fact that there were multiple lesions deemed a lobectomy as the appropriate course of treatment. This case emphasizes that attention should be paid to cases of multiple PAVM since cerebral infarction may arise from the disease.

关键词： Pulmonary Arteriovenous Malformation (PAVM) Brain Abscesses Cerebral Infarctions

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Clinicopathological Study of Neuroendocrine Carcinoma of the Breast

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Journal of Cancer Therapy 2017年第8期8卷 793-799页

作者： Masahiro Kitada Shunsuke Yasuda Masahiro Abe nana takahashi Satoshi Okazaki Kei Ishibashi Satoshi Hayashi Department of Breast Disease Center Asahikawa Medical University Asahikawa Japan

Introduction: Neuroendocrine carcinoma (NEC) occurs mostly in the digestive organs, such as the pancreas and gastrointestinal tract, and the lungs. Primary NEC of the breast is a rare entity. There are not many studies on this disease, and this study was carried out in order to know the clinical pathology of this disease. Methods: Of 2354 patients who underwent surgery for breast cancer in our hospital during the period from January 2000 to July 2015, 8 (0.34%) were pathologically diagnosed with NEC of the breast. This study is retrospectively registered. Result: The histological types were small cell carcinoma in one patient and invasive ductal carcinoma (IDC) with neuroendocrine differentiation in the remaining 7. The mean patient age was slightly higher than that of patients with usual IDC. On pathological examination, the NEC tumors were more hormone dependent and often HER2 negative, as compared to usual IDC, though there was no significant difference in nuclear grade. The patients with NEC of the breast showed positivity for neuroendocrine markers on immunohistological staining, and had favorable outcomes. Conclusion: NEC of the breast is rare, and there is no established consensus regarding the pathological significance, prognosis, and treatment method. Further accumulation of cases is necessary.

关键词： Breast Cancer Neuroendocrine Carcinoma

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