Oncologic outcomes and technical considerations of nipple-sparing mastectomies in breast cancer: experience of 425 cases from a single institution.

BACKGROUND: Nipple-sparing mastectomy (NSM) is an advantageous treatment option, providing a complete cure and good cosmetic results. We tested whether NSM is a surgically and oncologically safe technique. METHODS: We evaluated the oncological outcome of 425 breasts in 413 patients who underwent NSM between January 2000 and March 2013. We retrospectively reviewed patient data and analyzed all patient characteristics as potential risk factors of recurrence at the nipple-areola complex (NAC). To confirm the oncological safety of NSM, we compared outcomes of NSM and conventional total mastectomy. RESULTS: The median follow-up time after surgery was 46.8 months (range 6-158 months). Nipple necrosis was observed in 6 cases (1.4 %). The cumulative local recurrence rate after NSM was 5.8 % (25/425 cases), similar to that of conventional total mastectomy in the same period (5.6 %, 49/878 cases). Furthermore, the cumulative local recurrence rate at the NAC was 2.3 % (10 cases). HER2-enriched tumors and young age (<40 years) were significant risk factors for recurrence at the NAC. In patients with recurrence, the site of recurrence was easily excised, and good cosmetic results were achieved in breast reconstruction cases. CONCLUSION: NSM is safe with a low complication rate. No significant difference was observed in cumulative local recurrence rate, cumulative distant disease recurrence rate, and overall survival between patients who underwent NSM or conventional total mastectomy, confirming that NSM was surgically and oncologically safe.

Eosinophilic lung disease complicated by Kimura's disease: a case report and literature review.

Kimura's disease (KD) or eosinophilic lymphogranuloma is a rare chronic inflammatory disorder of unknown etiology that occurs primarily in Asians. A 51-year-old man diagnosed three years earlier with KD of a left neck nodule was admitted to our hospital with a productive cough and pulmonary infiltration. Bronchoscopy was performed, and a diagnosis of eosinophilic lung disease (ELD) was made. The patient's condition improved after receiving corticosteroid treatment. Complications such as nephrotic syndrome have been reported in patients with KD; however, ELD has not been previously described. To the best of our knowledge, this is the first report of ELD related to KD.

[A case of pseudo-meigs syndrome due to ovarian clear cell adenocarcinoma].

A 59-year-old woman was admitted with dyspnea. A chest X-ray film revealed a large amount of pleural effusion at the both sides. No malignant cells were found in bilateral pleural effusions. Computed tomography (CT) of the abdomen showed a huge mass of the right ovary with a small amount of ascites, suggesting a diagnosis of Meigs syndrome. The ovarian mass and the neighboring organs, including the uterus and the greater omentum, were surgically removed, and then both the bilateral pleural effusion and ascites disappeared after the surgery. The histopathological examination revealed that the mass was clear cell adenocarcinoma of the ovary (stage IIc), indicating that the disease was pseudo-Meigs Syndrome. This is the second report of pseudo-Meigs Syndrome caused by clear cell adenocarcinoma of the ovary in Japan.

Tumor debulking by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated with pulmonary carcinoma.

A 73-year-old male with stage IV lung adenocarcinoma presented with leg swelling and clubbing of the fingers on both hands upon physical examination, and bone scintigrams demonstrated marked accumulation of 99mTc-MDP in the long bones adjacent to the patellae. A diagnosis of hypertrophic pulmonary osteoarthropathy associated with primary lung cancer was made. Radiofrequency ablation (RFA) was utilized for cytoreduction, because the patient refused chemotherapy. One-month follow-up CT scans revealed low density of the ablated area associated with ablation necrosis. Cytoreduction by RFA rapidly alleviated the arthralgia and swelling, but not the clubbing of fingers. Follow-up bone scintigrams demonstrated a reduction in patellar uptake after RFA.