第15巻 2019年10月　第4号

■症例報告

乳癌術後半年で骨髄癌症を呈し急速な転帰で死亡に至った1例
関　奈紀¹, 横山　正¹, 丸山　弘¹, 牧野　浩司¹, 吉田　寛², 武井　寛幸^3
1日本医科大学多摩永山病院消化器・乳腺・一般外科
²日本医科大学付属病院消化器外科
³日本医科大学付属病院乳腺科

A Case of Bone Marrow Carcinomatosis Developing 6 Months after Surgery for Breast Cancer and Resulting in Rapid Death
Natsuki Seki¹, Tadashi Yokoyama¹, Hiroshi Maruyama¹, Hiroshi Makino¹, Hiroshi Yoshida² and Hiroyuki Takei^3
1)Department of Gastrointestinal, Breast and General Surgery, Nippon Medical School Tama Nagayama Hospital
²⁾Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital
³⁾Department of Breast Oncology, Nippon Medical School Hospital

A 52-year-old woman diagnosed at our hospital with breast cancer (ER-/PgR-/HER2-) with lymph node and bone metastasis was given systemic chemotherapy with epirubicin plus cyclophosphamide and zoledronic acid. This proved ineffective, so breast-conserving surgery with axillary lymph node dissection was performed for the purpose of local control and pathological evaluation. The pathological therapeutic effect was classified as grade 1, and the endocrine receptor status changed to positive. After surgery, the patient received chemotherapy with docetaxel plus cyclophosphamide twice and paclitaxel twice. Endocrine therapy was subsequently administered. One month after the start of endocrine therapy, the patient experienced pain throughout her body and fatigue, and a blood test showed thrombocytopenia. A bone marrow biopsy led to a diagnosis of disseminated carcinomatosis of the bone marrow resulting from metastatic breast cancer. Her symptoms did not improve even after hospital treatment, and she died 6 months after the breast surgery. This case of breast cancer resulting in rapid death from disseminated intravascular coagulation (DIC) caused by disseminated carcinomatosis of the bone marrow illustrates the urgent need for further consideration of the risk factors for this disease and determination of optimal therapy.

日医大医会誌 2019; 15(4), 182-186

Key words
bone marrow carcinomatosis, breast cancer, disseminated intravascular coagulation

Correspondence to
Natsuki Seki, Department of Gastrointestinal, Breast and General Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
E-mail：s9054@nms.ac.jp

受付：2019年5月27日　受理：2019年7月4日