GEÇ BAŞLAYAN, SOLİTER KEMİK METASTAZI İLE PREZENTE OLAN PROKSİMAL HUMERUS LEZYONU: 12 YILLIK REMİSYONDAN SONRA TANISAL BİR ZORLUK

Öz

Meme kanseri kadınlarda en sık görülen tümörlerden biridir. Her sekiz kadından biri hayatının bir noktasında bu hastalıkla karşılaşabilir ve metastaz, uzun yıllar süren remisyondan sonra bile gelişebilir. Bu olgu sunumunda, 2012'nin başlarında sol memede karma tip (invaziv duktal ve lobüler) karsinomu teşhisi konulan ve 12 yıl remisyon boyunca modifiye radikal mastektomi ve adjuvan tedaviler uygulanan 60'lı yaşlarındaki bir kadında sağ omuzda ağrı ve şişlikle ortaya çıkan nadir bir humerus metastazı anlatılmaktadır. Pozitron emisyon tomografisi görüntüleme, proksimal sağ humerusta hipermetabolik bir lezyon ortaya koydu. Manyetik rezonans görüntüleme ve biyopsi, metastatik meme kanserini gösteren kötü huylu bir epitel tümör ortaya koydu. Hastaya palyatif radyoterapi uygulandı ve sistemik tedavi olarak ribociclib (Valamor) başlandı. Ancak, tedavi nedeniyle ellerde ve yüzde yaygın kaşıntı ve vitiligo benzeri cilt değişiklikleri gelişti. Bu vaka, meme kanseri hastalarında uzun dönem klinik ve radyolojik takibin önemini ve geç dönemde ortaya çıkabilecek iskelet metastazlarına karşı dikkatli olunması gerektiğini vurgulamaktadır.

Anahtar Kelimeler

• Kemik metastazı
• meme neoplazileri
• humerus
• lobüler karsinom
• geç nüks.

LATE-ONSET PROXIMAL HUMERUS LESION PRESENTING WITH SOLITARY BONE METASTASIS: A DIAGNOSTIC CHALLENGE AFTER 12 YEARS OF REMISSION

Öz

Breast cancer is one of the most common tumors in women. One in eight women may encounter this disease at some point in their lives, and metastasis may develop even after many years of remission. This case report describes a rare humerus metastasis presenting with pain and swelling in the right shoulder in a woman in her 60s who was diagnosed with mixed-type (invasive ductal and lobular) carcinoma of the left breast in early 2012 and who underwent modified radical mastectomy and adjuvant treatments for 12 years of remission. Positron emission tomography imaging revealed a hyper metabolic lesion in the proximal right humerus. Magnetic resonance imaging and biopsy revealed a malignant epithelial tumor indicating metastatic breast cancer. The patient underwent palliative radiotherapy and was started on ribociclib (Valamor) as systemic treatment. However, widespread itching and vitiligo-like skin changes developed on the hands and face due to the treatment. This case emphasizes the importance of long-term clinical and radiological follow-up and the need to be careful about skeletal metastases that may occur in the late period in breast cancer patients.

Anahtar Kelimeler

• Bone neoplasms
• breast neoplasms
• humerus
• lobular carcinoma
• neoplasm recurrence.

Kaynakça

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