A patient with carcinomatous peritonitis 21 years after surgery for breast cancer *
We encountered a patient with carcinomatous peritonitis 21 years after surgery for breast cancer. The 55-year-old patient had undergone a radical bilateral mastectomy for breast cancer 21 years before. She experienced abdominal distention and consulted our hospital. where she underwent extensive examinations and was diagnosed as having carcinomatous peritonitis. No abnormalities. except for hypertrophy of the greater omentum and ascites. were observed in the abdominal organs. Because the levels of the blood tumor markers BCA225 and CA15-3 were elevated. metastasis of breast cancer was suspected. immunohistochemical staining of the samples collected from the hypertrophied greater omentum by peritoneotomy demonstrated ER (+) and BRST-2 (+) suggesting that the lesion was a metastasis of her breast cancer. After one course of intravenous drip of docetaxel and abdominal administration of carboplatin. oral administration of medroxyprogesterone acetate (MPA) was added. No abnormal images were observed by abdominal CT after the first course of administration, and the turnor markers fell to within the normal levels after the second course of administration. After the third course of administration.no cancer cells were macroscopically observed in the abdominal cavity by peritoneotomy. and the greater omentum was excised. Then. four courses of chemotherapy were performed. After confinnation of the absence of recurrence and metastasis by various examinations, the patient was discharged from the hospital, and has been followed up for continuation ot MPA in the outpatient department. (Accepted on July 19, 2000) Kawasaki Igakkaishi 26 (3) : 155- 159. 2000
