使用利妥昔单抗联合白蛋白结合型紫杉醇和顺铂成功治疗并发滤泡性淋巴瘤和三阴性乳腺癌:病例报告和文献综述。
Successful Treatment of Concurrent Follicular Lymphoma and Triple-Negative Breast Cancer Using Rituximab Plus Nab-Paclitaxel and Cisplatin: A Case Report and Literature Review.
发表日期:2023
作者:
Zhou Zhu, Na Zhou, Shuangni Yu, Xin Gao, Xin Cheng, Yingyi Wang, Chunmei Bai
来源:
Bone & Joint Journal
摘要:
乳腺癌和非霍奇金淋巴瘤同时发生是一种罕见疾病,诊断和治疗都面临挑战。滤泡性淋巴瘤 (FL) 和三阴性乳腺癌 (TNBC) 的共存此前从未被描述过。 一名 46 岁女性,已有未经治疗的晚期高肿瘤负荷 FL 病史,因癌症入院。右乳肿块迅速进展。超声检查显示右乳有一 8.3 × 3.6 × 4.1 cm 的真菌性肿块,双侧腋窝淋巴结 (LN) 肿大。 PET-CT 显示右乳肿块、膈肌两侧淋巴结、增大的脾脏和骨髓中 18F-FDG 活性增加。右乳肿块活检显示 TNBC。患者接受R-CHOP新辅助治疗,乳腺肿瘤获得部分缓解。然而,TNBC 在三个 R-CHOP 周期后出现进展。根据乳腺肿块的下一代测序(NGS)检测显示同源重组修复(HRR)缺陷(HRD)评分为72,新辅助治疗方案改为利妥昔单抗加白蛋白结合型紫杉醇和顺铂(R-TP),结果肿瘤显着消退。然后,患者接受了右乳房切除术和腋窝淋巴结清扫术。手术后,她接受定期监测,并接受 R-TP 和放射治疗的辅助治疗。FL 和 HRD 阳性 TNBC 的共存给诊断和治疗带来了挑战。基于多学科团队 (MDT) 讨论和 NGS 的有理有据的新辅助策略保证了本例的良好结果。© 2023 Zhu 等人。
Co-occurrence of breast cancer and non-Hodgkin's lymphoma is a rare condition with diagnostic and therapeutic challenges. The coexistence of follicular lymphoma (FL) and triple-negative breast cancer (TNBC) has not been described previously.A 46-year-old woman, already suffering a history of untreated, advanced-stage, high tumor burden FL, was admitted for a rapidly progressing right breast mass. Ultrasonography showed an 8.3 × 3.6 × 4.1 cm fungating mass in the right breast with enlarged lymph nodes (LNs) in bilateral axillae. PET-CT demonstrated increased 18F- FDG activity in right breast mass, LNs on both sides of the diaphragm, enlarged spleen, and bone marrow. Biopsy of the right breast mass revealed TNBC. The patient underwent neoadjuvant therapy with R-CHOP and achieved partial response of breast tumor. However, TNBC progressed after three cycles of R-CHOP. According to the next-generation sequencing (NGS) assay on breast mass showing a homologous recombination repair (HRR) deficiency (HRD) score of 72, the neoadjuvant regimen was changed to rituximab plus nab-paclitaxel and cisplatin (R-TP) and resulted in significant tumor regression. The patient then underwent right mastectomy with an axillary LN dissection. After the surgery, she was regularly monitored and given adjuvant therapy with R-TP and radiotherapy.The coexistence of FL and HRD-positive TNBC poses diagnostic and treatment challenges. Well-founded neoadjuvant strategy based on multidisciplinary team (MDT) discussion and NGS warranted a good outcome in this case.© 2023 Zhu et al.