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Rev. venez. oncol ; 24(4): 305-309, oct.-dic. 2012. ilus
Article in Spanish | LILACS | ID: lil-704395

ABSTRACT

Presentacion de un caso raro. Paciente femenina de 55 años quien presenta desde mayo 2011 prurito en pezón derecho, telorrea verdosa e hiperpigmentación del complejo areola-pezón. Se realiza mamografía y ultrasonido mamario que concluyen BIRADS0, ausencia de imágenes de sospecha, respectivamente. Se practica biopsia punch que reporta nevus displásico vs., melanoma superficial y biopsia excisional con hallazgos histopatológicos e inmunohistoquímicos compatibles con melanoma superficial Breslow 1 Clark I. Se lleva acabo resección de pezón, parte de la areola y tejido centro-mamario más biopsia de ganglio centinela, con técnica combinada, resultando positivo para melanoma metastásico por lo que se realiza disección axilar de niveles I al III. El estudio anatomopatológico definitivo reporta carcinoma ductal infiltrante, receptores hormonales negativos, Her2neu sobre-expresado, Ki67 5%, pT2pN0M0 clasificado como estadio IIA y melanoma en complejo areola pezón pT1apN1bM0 clasificado como estadio IIIC. Recibió interferón a altas dosis y quimioterapia a base de ciclofosfamida, adriamicina, fluoracilo, trastuzumaby radioterapia. El melanoma de la mama es una entidad poco frecuente (0,28%), varios estudios epidemiológicos han provisto evidencia sugestiva de la relación entre carcinoma de mama y melanoma. La asociación metacrónica de estas neoplasias ha sido descrita. Sin embargo, la sincronía de estas no ha sido reportada, por lo cual el presente caso debe ser considerado inédito


To present a rare and synchronic case. A 55 years old female patient has view for itchy in the right nipple, green telorrea and hyperpigmentation of the nipple-areola complex since May of 2011. The nmammography and the breast ultrasound concluding a BIRADS 0 and absence of images of suspected respectively. The punch biopsy was performed and which reported melanoma vs. dysplastic nevi superficial. The excisional biopsy with histopathological and the immunohistochemical findings support a superficial melanoma classified how a Breslow 1 Clark I. A resectionof the nipple, areola and mammary tissue plus sentinel lymph node biopsy was carried out, resulting positive for metastatic melanoma so we performed axillaries lymph node dissection of levels I to III. The final pathology study reports infiltrating ductal carcinoma, negative to hormone receptors, over expressed Her2/neu, Ki67 5%, pT2pN0M0, classifiedhow stage IIA, and melanoma of nipple areola complex pT1apN1bM0 classified how stage IIIA. She received high-dose interferon and cyclophosphamide, adriamycin, fluorouracil based chemotherapy, trastuzumab and radiation therapy. Melanoma of the breast is uncommon (0.28%). Several epidemiological studies have provided suggestive evidence of the relation ship between breast carcinoma and melanoma. Metachronous association of these neoplasms has been described. However, the synchrony of these has not been reported, so this case should be considered unpublished


Subject(s)
Female , Middle Aged , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Ductal, Breast/pathology , Melanoma/pathology , Breast Neoplasms/diagnosis , Biopsy, Needle/methods , Mammography/methods , Medical Oncology
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