We report a case of a 45-year-old Japanese women with adenoid squamous cell carcinoma (ASCC) of the left breast skin. The patient had showed a large mass in the left breast region with axillary swelling about 1 year before admission. Grossly, the tumor was an extensively ulcerated and elevated lesion measuring 15 x 16 x 5cm. Based on the tumor biopsy and cytologic examination of the axillary lymph nodes, squamous cell carcinoma (SCC) was diagnosed. No evidence of distant metastasis was identified. A modified radical mastectomy with left axillary node dissection was performed. Microscopically, the resected tumor showed on invasive proliferation of atypical squamous cells with marked keratinization. At the periphery of the tumor, an adenoid growth pattern was frequently seen with a transitional area showing squamous cell carcinoma and adenoid growth components. ASCC was diagnosed. A transition between the overlying squamous cell epithelium and squamous cell carcinoma component was also seen, thus the tumor was thought to haveoriginated from the breast skin. The patient died of respiratory failure due tomultiple lung metastasis about 1 month after the mastectomy. Tumor rarely originates at the breast region to include both the mammary glands and breast skin. The pathogenesis and management of ASCC are discussed following the presentation of this case.
Among 28 resected cases of carcinoma of the pancreas, 24 excepting 4 death cases due to operation or other diseases were clinicopathologically studied. The 24 patients could be classified by macroscopical staging as 6 in stage II, 11 in stage III, and 7 in stage IV. Histologically there were 13 curative resection and 11 noncurative resection cases. In 13 histologically curative cases one-, 3-or 5-year survival rate was 50%, 37.5%, or 37.5%, respectively. While 11 noncurative cases included no survivals longer than 23 months, and the one-year survival rate was 21.8%. When compared with long survival cases for histological type, moderately differentiated tubular adenocarcinoma appeared predominant in cancer-deaths within one year and noncurative resection cases. As to histological tumor extension, both two long survivers had sa, rpa, n(-), and pv0v0; cancer-deaths were positive against all factors excepting pv; and noncurative resection cases tended to have an extrapancreatic extension. Four of 6 curative resection cases were found to have liver metastasis by necropsy, which indicated that the important factor for long survival might lie on active approach to prevent the liver from metastasizing.
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