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Misdiagnosed male breast cancer with an unknown primary tumor: A case report

机译：误诊为原发性肿瘤的男性乳腺癌：一例报告

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摘要

Compared with female breast cancer, male breast cancer (MBC) has an extremely low morbidity, later staging and fewer breast tissues. The lumps are easier to invade in the center and the majority of the cases are positive for metastatic lymph node, with the typical clinical manifestation as a painless mass in partial breast. MBC with an unknown primary tumor is rare and is often prone to misdiagnosis, resulting in a delay in correct treatment. Such a case is extremely significant for clinical reference. The current study presents a 58-year-old male who developed a painless mass in the left armpit and received armpit mass biopsy and pathological examination which showed glandular cancer, with a high possibility of mammary primary tumor. The patient was administered four cycles of paclitaxel plus oxaliplatin chemotherapy. However, three months later, the patient identified novel disseminated lymph nodes in the left armpit. The initial pathological section and paraffin blocks were re-examined and the patient was finally diagnosed with breast invasive ductal carcinoma based on the metastases pathology and immunohistochemical examination. No breast mass was found on physical examination of the patient and the tumor markers, including cancer antigen 125 and carcinoembryonic antigen, were normal. No primary tumors were observed in the mammography and PET-CT and the primary tumor was not found following the left breast modified radical mastectomy.
机译：与女性乳腺癌相比，男性乳腺癌（MBC）的发病率极低，分期晚，乳腺组织少。肿块更容易在中心侵入，大多数病例转移性淋巴结阳性，典型的临床表现是部分乳房无痛性肿块。伴有未知原发肿瘤的MBC很少见，常常易于误诊，导致正确治疗的延迟。这种情况对于临床参考极为重要。当前的研究表明，一名58岁的男性在左腋窝无痛性肿块，并接受了腋窝肿块活检和病理检查，显示为腺癌，极有可能发生乳腺原发性肿瘤。该患者接受了紫杉醇联合奥沙利铂化疗的四个周期。但是，三个月后，患者在左腋窝发现了新的弥漫性淋巴结。重新检查最初的病理切片和石蜡块，并根据转移病理学和免疫组织化学检查，最终将患者诊断为乳腺浸润性导管癌。对该患者进行身体检查未发现乳房肿块，并且包括癌症抗原125和癌胚抗原在内的肿瘤标志物均正常。在乳房X光检查和PET-CT中未观察到原发性肿瘤，在左乳房改良根治性乳房切除术后未发现原发性肿瘤。

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