医学专题—浅谈骨转移性乳腺癌20994.ppt

Metastatic Breast cancer Case Report第一页，共二十三页。General informationName:WU ChunHongAge:40y Sex:FemaleDate of admission:February 9th,2011Date of discharge:April 23th,2011第二页，共二十三页。Chief complaintShe got hypoesthesia of lower limbs and inability to walk for more than a month第三页，共二十三页。History of present illnessThe patient felt pain on the back by no obvious incentives in June 2010The pain was tingling,especially in night-timeThe patient took orally traditional Chinese medicine,but had not tangible effects第四页，共二十三页。Past,Personal&Family HistoryNo hepatitis,hypertension,or diabetesNo smoking,alcohol or drug abuseNo inherited diseasesNo history of drug allergyNormal menstruation第五页，共二十三页。Clinical findingsThe left breast presented with diffused erythema and edema,induration about size of 3.0cm*3.0cm第六页，共二十三页。Ultrasound examinationa 3 cm left breast mass and a normal right breast 第七页，共二十三页。Thoracic MRI examination 第八页，共二十三页。Thoracic MRI examinationHigh-density mass was shown on the seventh thoracic,and bone destruction also had been found.Enhanced MRIEnhanced MRI第九页，共二十三页。Laboratory examination2011-02-09 1.Hepatic functions ALT 40 U/L AST 20 U/L TB Normal3.Tumor markers CA19-9 Normal2.Blood routine test Hb 82 g/L RBC 4.541012/L WBC 6.1109/L PLT 201 109/L 第十页，共二十三页。puncture biopsyShe received ultrasound guided breast core needle puncture biopsy Puncture tissue pathology:The left breast invasive ductal carcinoma第十一页，共二十三页。Primary diagnosis Breast cancer with bone metastasis第十二页，共二十三页。TreatmentOn February 11,2011 in orthopedic department,The Patient receivedthe seventh thoracic tumor resection and pedicle screw fixation第十三页，共二十三页。Histological examinationSeventh thoracic tumors was identified as metastatic carcinoma,and the immunohistochemistry results showed the possibility of breast cancer bone metastasis was very large第十四页，共二十三页。IMMUNOHISTOCHEMICAL RESULTSER+PR+CerbB2-CK20-EMA+,Ckpan+,CK5/6-第十五页，共二十三页。TreatmentThe patient recovered well,and then transferred into our departmentChemotherapy two times before operation:February 23,2011 March 20,2011 The chemotherapy plan was TEC第十六页，共二十三页。TreatmentAfter the chemotherapyThe lesions area of left breast showed no reduction 第十七页，共二十三页。TreatmentModified radical mastectomy on Modified radical mastectomy on marchmarch31,201131,2011Bilateral oophorectomyBilateral oophorectomyOn the same dayOn the same day第十八页，共二十三页。Histological examinationThe left breast invasive ductal carcinomaThe basal resection margin of tumor was close to the surrounding normal tissueThe axillary lymph nodes metastasis(13/15)第十九页，共二十三页。ImmunohistochemicalER+PR+CerbB2-E-cad+,Ki6750%+,P53+,Ck5/6-第二十页，共二十三页。TreatmentAfter operation,the patient continued to receive chemotherapy and radiotherapy.第二十一页，共二十三页。Thank you第二十二页，共二十三页。内容(nirng)总结Metastatic Breast cancer。2011-02-09。AST 20 U/L。EMA+,Ckpan+,CK5/6-。E-cad+,Ki6750%+,P53+,Ck5/6-。Thank you第二十三页，共二十三页。