腋窩補助乳癌に対してラティッシムス・ドルシ筋皮下フラップ再建術を施行した1例

[A Case of Axillary Accessory Breast Cancer Treated via Latissimus Dorsi Musculocutaneous Flap Reconstruction].

• Sakiko Yabe
• Goshi Oda
• Tsuyoshi Nakagawa
• Mai Kasahara
• Yuichi Kumaki
• Tomoyuki Fujioka
• Kazunori Kubota
• Lichirou Onishi
• Hiroyuki Uetake

抄録

46歳女性が8年前から自覚していた左腋窩腫瘤肥大を主訴に来院した。触診の結果、腫瘤は15mmの大きさであった。また，皮膚の発赤，集簇が認められた．左腋窩のマンモグラフィでは皮膚浸潤を伴う不規則な腫瘤を認めた．乳房超音波検査では左腋窩に低エコーの腫瘤を認め、皮膚から連続していた。コアニードル生検で浸潤性管腔癌と診断した。乳房には他の病変は認められず、他の臓器にも原発性病変は認められなかった。腋窩従属乳癌と診断され、局所広範切除と腋窩リンパ節郭清を行った。皮膚欠損が広範囲に及んでいたため、上肢拘縮を予防するために大胸筋筋皮下フラップを用いた腋窩再建術を行った。現在は上肢を動かすことができ、リンパ浮腫は認められていない。皮膚浸潤を伴う腋窩従属乳癌の場合には、大胸筋筋皮下フラップを用いた腋窩再建術が有用である。

A 46-year-old woman visited our hospital with the chief complaint of left axillary mass enlargement, which she had been aware of for 8 years. Palpation revealed that the mass was 15mm in size. Redness and gathering of the skin were also observed. Mammographic imaging of the left axilla revealed an irregular mass with skin infiltration. Breast ultrasonography revealed a low echo mass in the left axilla, which was continuous from the skin. Core needle biopsy was used to diagnose the tumor as an invasive ductal carcinoma. No other lesions were observed in the breast, and primary lesions were not found in any other organs. The patient was diagnosed with axillary accessory breast cancer and underwent local extensive resection and axillary lymph node dissection. Because the skin defect was widespread, we performed axillary reconstruction using the latissimus dorsi musculocutaneous flap to prevent upper limb contracture. At present, she can move her upper limbs and lymphedema has not been observed. In cases of axillary accessory breast cancer with skin infiltration, reconstruction using the latissimus dorsi musculocutaneous flap can be a useful procedure.