title: [A Case of Recurrent Breast Cancer with Adrenal Metastasis Resected Using Laparoscopic Surgery].
abstract: We report a case of recurrent breast cancer with involvement of the right adrenal grand, which was resected using laparoscopic surgery. The patient was a 41-year-old woman who underwent duct-lobular segmentectomy for ductal carcinoma in situ. Histopathology showed microinvasion, and tested positive for ER and PR, but negative for HER2, so we applied radiation to the remaining breast and administered tamoxifen. After 9 months, local recurrence was detected and quadrantectomy with axillary lymph node dissection was performed. One year and 10 months later, local recurrence was again detected and a tumorectomy was performed. The adjuvant therapy was changed to an LH-RH analog plus anastrozole and it was administered effectively for 5 years. Left ileal metastasis appeared in the 2nd month after completion of the adjuvant chemotherapy, so radiation was applied and an LH-RH analog plus exemestane administration was started. Three years passed without recurrence, but a right adrenal tumor appeared on computed tomography. The tumor grew over 6 months, so laparoscopic right adrenalectomy was performed. Histopathologically, the tumor tested positive for ER and PR, and negative for HER2 so we diagnosed metastasis of breast cancer, and administered an LH-RH analog plus exemestane. The patient's disease has not progressed in the 3 months since surgery.
authors.affiliation: Dept. of Surgery, National Hospital Organization Osaka National Hospital.
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Murakami
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohtani
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Kiyo
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasojima
authors.forename: Makiko
authors.initials: M
authors.lastname: Mizutani
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mori
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D015412:Mastectomy, Segmental; D012008:Recurrence; D016896:Treatment Outcome