[A Case of Male Mammary' Paget's Disease].

A 90-year-old male visited our hospital because redness of his left chest. An erythema of 25 mm in size with indistinct border was observed on the left nipple, and mammary' Paget's disease was diagnosed with a skin biopsy. Ultrasound examination revealed no significant findings in the mammary gland, so a left mastectomy was performed under local anesthesia. The final pathological diagnosis was mammary' Paget's disease with noninvasive ductal carcinoma in the duct. We have experienced a very rare male mammary' Paget's disease because both male breast cancer and mammary' Paget's disease are rare.

[Thyroid Metastasis of Rectal Cancer].

A 65-year-old woman underwent laparoscopic low anterior resection for rectal cancer with distant metastasis to the right lobe of her liver and mediastinal and right subclavian lymph nodes. Since the postoperative chemotherapy resulted in the disappearance of the lymph node metastasis and diminished hepatic metastasis lesion, the enlarged anterior segment of the liver was performed. She was administered chemotherapy for 1 year after the second surgery. Thoracoabdominal computed tomography performed 18 months after the end of the treatment revealed swelling of the left lobe of the thyroid. Ultrasonography showed a 23mm lobulated hypoechoic tumor in the left lobe of the thyroid gland. We suspected thyroid metastasis by aspiration biopsy cytology. Left thyroid lobectomy was performed for definitive diagnosis and local control. Histological examination revealed thyroid metastasis of the rectal cancer. We experienced a rare case of thyroid metastasis from rectal cancer.

[A Case of an Elderly Male with Breast Cancer with Synchronous Triple Cancer of the Lung and Stomach].

An 89-year-old male was diagnosed with advanced gastric cancer during an upper gastrointestinal endoscopy for gastric polyp follow-up. Positron emission tomography revealed tumors with 18F-fluorodeoxyglucose(FDG)accumulation in the right lung and right breast. Incisional biopsy of the right breast tumor was performed and the tumor was diagnosed as primary breast cancer(ER: 90%, PgR: 70%, HER2: 1+, Ki-67: 17%). Since it was difficult to distinguish whether the lung tumor was primary lung cancer or metastasis, a bronchoscopic biopsy was performed. Histopathological examination revealed that the lung tumor was primary lung cancer. Thus, this male patient had simultaneous triple gastric, breast, and lung cancer. Total mastectomy was performed for the breast cancer under local anesthesia and adjuvant endocrine therapy was started. Stereo- tactic body radiation therapy(48 Gy/4 Fr/4 days)for lung cancer and partial gastrectomy for gastric cancer were subsequently performed. Although male breast cancer itself is rare, we experienced a very rare case of male breast cancer with simultaneous lung and gastric cancer.