Kyushu University Academic Staff Educational and Research Activities Database
List of Reports
Makoto Kubo Last modified date:2021.06.02

Associate Professor / Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University / Department of Clinical Medicine / Faculty of Medical Sciences


Reports
1. Shimazaki A, Hashimoto T, Kai M, Nakayama T, Yamada M, Zaguirre K, Tokuda K, Kubo M, Yamaura K, Nakamura M, Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report, Surg Case Rep, 10.1186/s40792-020-01068-5, 7(1), 2021.04, Abstract
Background: Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease.
Case presentation: The patient was diagnosed with EPP at the age of 33 and had a rich family history of the disease. For right breast cancer initially considered as TisN0M0 (Stage 0), the right mastectomy and sentinel lymph node biopsy were performed, while the final stage was pT1bN0M0, pStage I. In the perioperative period, we limited the drug use and monitored light wavelength measurements. Besides, we covered surgical lights, headlights, and laryngoscope's light with a special polyimide film that filtered the wavelength of light causing dermal photosensitivity. After the surgery, any emerging complications were closely monitored.
Conclusions: The surgery, internal medicine, anesthesiology, and operation departments undertook all possible measures through close cooperation to ensure a safe surgery for the patient with a rare condition.
Keywords: Breast cancer surgery; Erythropoietic protoporphyria (EPP); Photosensitivity..
2. Harada Y, Kubo M, Kai M, Yamada M, Zaguirre K, Ohgami T, Yahata H, Ohishi Y, Yamamoto H, Oda Y, Nakamura M, , Breast metastasis from pelvic high‑grade serous adenocarcinoma: a report of two cases, Surg Case Rep, 10.1186/s40792-020-01090-7 , 6(1):317, 2020.04, Abstract
ackground: Metastatic tumors to the breast reportedly account for 0.5% to 2.0% of all malignant breast diseases. Such metastatic tumors must be differentiated from primary breast cancer. Additionally, few reports have described metastases of gynecological cancers to the breast. We herein report two cases of metastasis of pelvic high-grade serous adenocarcinoma to the breast.
Case presentation: The first patient was a 57-year-old woman with a transverse colon obstruction. Colostomy was performed, but the cause of the obstruction was unknown. We found scattered white nodules disseminated throughout the abdominal cavity and intestinal surface. Follow-up contrast-enhanced computed tomography (CT) showed an enhanced nodule outside the right mammary gland. Core needle biopsy (CNB) of the right breast mass was conducted, and immunohistochemical staining of the mass suggested a high-grade serous carcinoma of female genital tract origin. We diagnosed the patient's condition as breast and lymph node metastasis of a high-grade serous carcinoma of the female genital tract. After chemotherapy for stage IVB peritoneal cancer, tumor reduction surgery was performed. The second patient was a 71-year-old woman with a medical history of low anterior resection for rectal cancer at age 49, partial right thyroidectomy for follicular thyroid cancer at age 53, and left lower lung metastasis at age 57. Periodic follow-up CT showed peritoneal dissemination, cancerous peritonitis, and pericardial effusion, and the patient was considered to have a cancer of unknown primary origin. Contrast-enhanced CT showed an enhanced nodule in the left mammary gland with many enhanced nodules and peritoneal thickening in the abdominal cavity. CNB of the left breast mass was conducted, and immunohistochemical staining of the mass suggested a high-grade serous carcinoma of female genital tract origin. After chemotherapy for stage IVB peritoneal cancer, tumor reduction surgery was performed.
Conclusions: We experienced two rare cases of intramammary metastasis of high-grade serous carcinoma of female genital tract origin. CNB was useful for confirming the histological diagnosis of these cancers that had originated from other organs. A correct diagnosis of such breast tumors is important to ensure quick and appropriate treatment.
Keywords: Breast metastasis; Core needle biopsy; Hereditary breast and ovarian cancer syndrome; Peritoneal cancer
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3. Kai M, Kubo M, Kawaji H, Kurata K, Mori H, Yamada M, Nakamura M, QOL-enhancing surgery for patients with HER2-positive metastatic breast cancer, BMJ Support Palliat Care, 10.1136/bmjspcare-2018-001622., 9(2):151-154, 2018.04.
4. Kai M, Kubo M, Kawaji H, Kurata K, Mori H, Yamada M, Nakamura M, QOL-enhancing surgery for patients with HER2-positive metastatic breast cancer, BMJ Support Palliat Care, 10.1136/bmjspcare-2018-001622., 9(2):151-154, 2018.04.