Okayama Igakkai Zasshi (Journal of Okayama Medical Association)

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A 73-year-old woman was admitted for closer investigation into an abdominal tumor. Abdominal ultra-sonography, CT, and magnetic resonance imaging showed a discrete abdominal tumor. Especially on MRI, the tumor appeared as a relatively ill-defined whorled soft-tissue thickening within the mesenteric fat, causing angulation or speculation of adjacent bowel mesentery. Surgery was performed under a presumptive diagnosis of a mesojejunum desmoid. The tumor was invading the transverse mesocolon and mesojejunum as well as the third portion of the duodenum and the middle colic artery, and it was close to but apart from the superior mesenteric artery. The tumor was resected, including removal of part of the duodenum and transverse colon. The specimen contained a white solid tumor measuring 14×12×8cm. Pathologic examination showed differentiated fibroblasts and copious collagen fibers. The tumor was negative for CD34, c-kit, S-100, and α-SMA, but positive for β-catenin. On the basis of these findings, we established a diagnosis of mesenteric desmoid tumor of the small intestine. The patient has been followed postoperatively for 2 years, no sign of recurrence, to date.

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We treated two patients with a rare metaplastic carcinoma of the breast. Patient 1：A 32-year-old woman presented with a rapidly growing mass（ 7cm） in her right breast. We diagnosed cT3N0M0 Stage IIB breast cancer and performed a radical resection. The pathological diagnosis was triple-negative metaplastic carcinoma with a Ki-67 value ＞30%. Postoperative adjuvant chemotherapy and radiotherapy were performed. Patient 2：A 66-year-old postmenopausal woman presented with a left breast mass. We diagnosed cT1N0M0 Stage I breast cancer and performed a radical resection. The pathological diagnosis was triple-negative metaplastic carcinoma with a Ki-67 value ＞30%. Postoperative adjuvant chemotherapy was performed. Patients 1 and 2 have achieved relapse-free survivals of 1 year＋2 months and 10 months, respectively. Metaplastic carcinoma of the breast is a rare tumor, and its prognosis is not favorable. The only available treatment is that used for invasive ductal carcinoma；a more specific treatment has not been established. The accumulation of further similar cases and the development of a novel effective treatment are desired.

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