背景:男性乳腺癌(MBC)相对罕见,约占美国所有男性癌症的1%,占全球乳腺癌的0.6%。在尼日利亚,尽管发病率因地区而异,范围为3.4%至9%,据指出,它正在增加。妇科乳房发育是一种有据可查的诱发因素,也是内源性和外源性雌激素。男性乳腺癌最常见的组织学亚型是浸润性导管癌。浸润性筛状癌,ICC,是一种极其罕见的变体,全球报告的病例不超过10例,当存在时,已被诊断为40岁以上的患者。
方法:我们介绍一个17岁的案例,男本科生,他因复发而向我们的诊所就诊,无痛,右乳房肿块。三年前,他在另一个健康场所切除了右乳房肿块,在组织病理学上被诊断为浸润性筛状癌。唯一已知的诱发因素是最初的肿块,在他10岁时被切除,组织学诊断为妇科乳房发育症.他接受了手术切除和腋窝淋巴结清除,组织病理学再次证实高级别浸润性筛状癌伴多发淋巴结转移,而免疫组织化学显示三重阴性特征。此后,他被转诊接受辅助治疗,对放疗反应良好。
结论:在所有女性乳房发育症病例中都需要高度怀疑,所有这些患者都应该接受随访。迅速干预,诉诸组织学,在注明的地方,免疫组织化学,很重要。
BACKGROUND: Male breast cancers (MBC) are relatively rare, accounting for about 1% of all male cancers in the US and 0.6% of breast cancers worldwide. In Nigeria, though the incidence varies per region, with a range of 3.4 to 9%, it is noted to be increasing. Gynaecomastia is a well-documented predisposing factor as well as endogenous and exogenous oestrogen. The most common histological subtype of male breast cancer is the invasive ductal carcinoma. Invasive
cribriform carcinoma, ICC, is an extremely rare variant, with no more than 10 cases reported worldwide and, when present, has been diagnosed in patients above 40 years old.
METHODS: We present the
case of a 17 year-old, male undergraduate student, who presented to our clinic on account of a recurrent, painless, right breast lump. Three years earlier he had had a right breast lump excised at another health facilityand this was diagnosed histopathologicallyas invasive
cribriform carcinoma. The only known predisposing factor was an initial lump, excised when he was 10 years old, and diagnosed histologically as gynaecomastia.He had surgical excision and axillary lymph node clearance,and histopathology re-confirmed high grade invasive
cribriform carcinoma with multiple lymph node metastases, while immunohistochemistry showed a triple negative signature. He was thereafter referred for adjuvant treatment and has responded well to radiotherapy.
CONCLUSIONS: There is need for a high index of suspicion in all cases of gynaecomastia, and all such patients should be followed up. Prompt intervention, recourse to histology, and where indicated, immunohistochemistry, are important.