浅谈骨转移性乳腺癌课件.ppt

1、Metastatic Breast cancer Case ReportGeneral informationGeneral information Name:WU ChunHong Age:40y Sex:Female Date of admission:February 9th,2011 Date of discharge:April 23th,2011Chief complaintChief complaint She got hypoesthesia of lower limbs and inability to walk for more than a monthHistory of

2、 pHistory of present resent illnessillness The patient felt pain on the back by no obvious incentives in June 2010 The pain was tingling,especially in night-time The patient took orally traditional Chinese medicine,but had not tangible effectsPast,Personal&Family History No hepatitis,hypertension,or

3、 diabetes No smoking,alcohol or drug abuse No inherited diseases No history of drug allergy Normal menstruationC Clinical findingslinical findingsThe left breast The left breast presented with presented with diffused diffused erythemaerythema and and edema,edema,indurationinduration about size of ab

4、out size of 3.0cm3.0cm*3.0cm3.0cmUltrasound Ultrasound examinationexaminationa 3 cm left breast mass and a normal right breast Thoracic MRI examination Thoracic MRI examinationHigh-density mass was shown on the seventh High-density mass was shown on the seventh thoracic,and bone destruction also had

5、 been found.thoracic,and bone destruction also had been found.Enhanced MRIEnhanced MRILaboratory examination 2011-02-09 1.Hepatic functions ALT 40 U/L AST 20 U/L TB Normal3.Tumor markers CA19-9 Normal 2.Blood routine test Hb 82 g/L RBC 4.541012/L WBC 6.1109/L PLT 201 109/L puncture biopsy She receiv

6、ed ultrasound guided breast core needle puncture biopsy Puncture tissue pathology:The left breast invasive ductal carcinomaPrimary diagnosisPrimary diagnosis Breast cancer with bone metastasisTreatmentTreatmentOn February 11,2011 in orthopedic department,The Patient receivedthe seventh thoracic tumo

7、r resection and pedicle screw fixationHistological examinationSeventh thoracic Seventh thoracic tumors was identified tumors was identified as metastatic as metastatic carcinoma,and the carcinoma,and the immunohistochemistryimmunohistochemistry results showed the results showed the possibility of br

8、east possibility of breast cancer bone cancer bone metastasis was very metastasis was very largelargeIMMUNOHISTOCHEMICAL resultsER+PR+CerbB2-CK20-EMA+,Ckpan+,CK5/6-TreatmentThe patient recovered well,and then transferred into our departmentChemotherapy two times before operation:February 23,2011 Mar

9、ch 20,2011 The chemotherapy plan was TECTreatmentTreatmentAfter the chemotherapyThe lesions area of left breast showed no reduction TreatmentModified radical Modified radical mastectomy on marchmastectomy on march31,201131,2011Bilateral Bilateral oophorectomyoophorectomyOn the same dayOn the same da

10、yHistological examinationThe left breast The left breast invasive invasive ductalductal carcinomacarcinomaThe basal resection The basal resection margin of tumor was margin of tumor was close to the close to the surrounding normal surrounding normal tissuetissueThe The axillaryaxillary lymph lymph nodes metastasis nodes metastasis(13/15)(13/15)ImmunohistochemicalER+PR+CerbB2-E-cad+,Ki6750%+,P53+,Ck5/6-Treatment After operation,the patient continued to receive chemotherapy and radiotherapy.Thank you