title: [A case of recurrent breast cancer with solitary adrenal metastasis treated with surgery and endocrine therapy].
abstract: We present a case in which a 46-year-old woman underwent mastectomy (Bt+AX) for right breast cancer (T4bN0M0, Stage IIIB) at the age of 42. A histopathological examination confirmed her cancer to be an invasive ductal carcinoma n (-),ER (+), PgR (+),HER 2 (1+). For postoperative medication therapy, she was taking goserelin plus tamoxifen for 2 years and tamoxifen thereafter. A right adrenal tumor was discovered during a follow-up CT scan and MRI after the operation. There was no indication of metastasis in any other location. A laparoscopic right adrenalectomy was performed to establish a definitive diagnosis and to cure the cancer. According to the histopathological examination, the tumor was ER (+), PgR (+), and HER2 (0) and metastasized from the breast. After this operation, the regimen was changed to high- dose toremifene as endocrine therapy. No recurrence of the cancer has been reported 2 years and 4 months after the operation. In most cases, metastasis to the adrenal gland is due to systemic metastasis as seen in the last stage of breast cancer, and a solitary adrenal gland metastasis from breast cancer is extremely rare. The combination of surgical removal and medication for solitary distant metastasis from breast cancer may be effective in improving the long-term survival rate.
authors.affiliation: Dept. of Surgery, Japanese Red Cross Okayama Hospital, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yoshitomi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsuji
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D017312:Toremifene / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017312:Toremifene