젊은 여성의 유방에 발생한 원발성 활막 육종 1예
A case of primary breast synovial sarcoma diagnosed in a young female patient
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
활막 육종은 주로 관절 주위 조직에 호발하는 악성 종양이다. 종종 관절 이외의 다른 부위에 발생하는 경우도 보고되어있는데, 원발성 유방 활막 육종은 세계적으로도 보고된 예가 드물다. 본 증례는 원발성 유방 활막 육종으로 진단된 15세 여자 환자의 1예이다. 진단 후 유방 종괴에 대한 광범위 절제술을 시행하였으나 9개월 후 국소 재발하였고, 이에 재발 부위에 대한 광범위 절제술을 다시 시행하였다. 그러나, 27개월 후 폐의 우상엽에 고립성 폐 전이가 발견되었다. 이에 폐 병변에 대한 절제술 및 고식적 화학요법으로 doxorubicin 및 ifosfamide의 병합 화학요법을 시행하였다. 현재 항암화학요법 종료 후 28개월째 재발의 증거 없이 경과관찰 중이다. 이에 저자들은 본 증례를 문헌고찰과 함께 보고하는 바이다.
Abstract
Synovial sarcoma is a malignant soft tissue neoplasm that develops mainly in para-articular locations in the extremities, but can arise in a wide variety of other sites. Primary breast synovial sarcoma has been reported infrequently worldwide. We report the case of 15-year-old female who was diagnosed with primary breast synovial sarcoma. We performed wide excision for the breast mass. However, local recurrence was detected 9 months later. We performed wide excision for the recurrent breast tumor. After 27 months, a solitary metastasis was found in the right upper lobe of the lung. We performed wedge resection for the lung mass and treated her with palliative chemotherapy using doxorubicin and ifosfamide. Twenty-eight months after chemotherapy, she is alive without evidence of recurrence. We report the details of this case along with a review of the literature.
참고문헌 (19)
- Fletcher CD, "WHO pathology and genetics: tumors of soft tissue and bone", pp.200~204 (2002), IARC Press
- Chan JA, "Synovial sarcoma in older patients: clinicopathological analysis of 32 cases with emphasis on unusual histological features", Histopathology, 43, pp.72~83 (2003)
- Adem C, "Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature", Br J Cancer, 91, pp.237~241 (2004)
- Singer S, "Synovial sarcoma: prognostic significance of tumor size, margin of resection and mitotic activity for survival", J Clin Oncol, 14, pp.1201~1208 (1996)
- Lewis JJ, "Synovial sarcoma: a multivariate analysis of prognostic factor factors in 112 patients with primary localized tumours of the extremity", J Clin Oncol, 18, pp.2087~2094 (2000)
- Eilber FC, "Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma", Ann Surg, 246, pp.105~113 (2007)
- Okcu MF, "Synovial sarcoma of childhood and adolescence: a multicenter, multivariate analysis of outcome", J Clin Oncol, 21, pp.1602~1611 (2003)
- Kawai A, "SYT-SSX gene fusion as a determinant of morphology and prognosis in synovial sarcoma", N Engl J Med, 338, pp.153~160 (1998)
- McCarter MD, "Randomized clinical trials in soft tissue sarcoma", Surg Oncol Clin N Am, 11, pp.11~22 (2002)
- Italiano A, "Neo", adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group, 2009, pp.20, 425~430
- Sleijfer S, "Using single-agent therapy in adult patients with advanced soft tissue sarcoma can still be considered standard care", Oncologist, 10, pp.833~841 (2005)
- Karavasilis V, "Significant clinical benefit of first-line palliative chemotherapy in advanced soft-tissue sarcoma: retrospective analysis and identification of prognostic factors in 488 patients", Cancer, 112, pp.1585~1591 (2008)
- Worden FP, "Randomized phase II evaluation of 6 g", m2 of ifosfamide plus doxorubicin and granulocyte colony-stimulating factor (G-CSF) compared with 12 g, J Clin Oncol, pp.2005, 23[DOI]
- Maurel J, "Efficacy of sequential high-dose doxorubicin and ifosfamide compared with standard-dose doxorubicin in patients with advanced soft tissue sarcoma: an open-label randomized phase II study of the Spanish group for research on sarcomas", J Clin Oncol, 27, pp.1893~1898 (2009)
- Canter RJ, "A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients", Clin Cancer Res, 14, pp.8191~8197 (2008)
- Lisle JW, "Risk assessment based on FDG-PET imaging in patients with synovial sarcoma", Clin Orthop Relat Res, 467, pp.1605~1611 (2009)
- Johnson GR, "Roles of positron emission tomography with fluorine-18-deoxyglucose in the detection of local recurrent and distant metastatic sarcoma", Clin Nucl Med, 28, pp.815~820 (2003)
- Nair N, "Unsuspected metastatic male breast nodule from synovial sarcoma detected by FDG PET", Clin Nucl Med, 30, pp.289~290 (2005)
- Yoshitani K, "Pelvic metastasis of breast synovial sarcoma", J Orthop Sci, 14, pp.219~223 (2009)