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中华妇幼临床医学杂志(电子版) ›› 2014, Vol. 10 ›› Issue (04) : 465 -468. doi: 10.3877/cma.j.issn.1673-5250.2014.04.013

所属专题: 文献

论著

泌乳腺瘤的临床分析及文献复习
高雅军1, 高海凤1, 汪洁1, 何湘萍1, 闫智清1, 马祥君1,*,*()   
  1. 1. 100080 北京市海淀区妇幼保健院乳腺病防治中心
  • 收稿日期:2013-12-15 修回日期:2014-05-15 出版日期:2014-08-01
  • 通信作者: 马祥君

Clinical Analysis of Lactating Adenoma and Related Literatures Review

Yajun Gao1, Haifeng Gao1, Jie Wang1, Xiangping He1, Zhiqing Yan1, Xiangjun Ma1()   

  1. 1. Center for Prevention and Cure of Breast Disease, Haidian Maternal and Child Health Hospital, Beijing 100080, China
  • Received:2013-12-15 Revised:2014-05-15 Published:2014-08-01
  • Corresponding author: Xiangjun Ma
  • About author:
    (Corresponding author: Ma Xiangjun, Email: )
引用本文:

高雅军, 高海凤, 汪洁, 何湘萍, 闫智清, 马祥君. 泌乳腺瘤的临床分析及文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2014, 10(04): 465-468.

Yajun Gao, Haifeng Gao, Jie Wang, Xiangping He, Zhiqing Yan, Xiangjun Ma. Clinical Analysis of Lactating Adenoma and Related Literatures Review[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2014, 10(04): 465-468.

目的

探讨泌乳腺瘤的病因、临床表现及治疗方法。

方法

选择2004年7月1日至2012年3月30日于北京市海淀区妇幼保健院乳腺病防治中心确诊的泌乳腺瘤患者5例及于Pubmed数据库及万方数据库检索的1988年7月20日至2012年6月21日报道的6例泌乳腺瘤患者的临床病历资料为研究对象(本研究遵循的程序符合北京市海淀区妇幼保健院乳腺病防治中心人体试验委员会制定的伦理学标准,得到该委员会批准)。回顾性分析本组患者的病因、临床表现、治疗方法、疗效及预后;并对相关文献进行复习总结。

结果

本院收治的5例患者中,1例于孕龄为17孕周发现乳腺肿块,孕龄为25孕周时行乳腺肿物切除术,术后组织病理学检査结果示泌乳腺瘤;2例患者先行脓肿切开引流术后形成乳漏窦道,再次行肿物切除+窦道切除术,术后愈合良好;1例于彩色多普勒超声引导下行4次乳房脓肿穿剌抽吸冲洗,感染控制后行乳房肿物切除术;1例行乳腺脓肿清创引流术时发现乳房内肿物予以切除。随访至今无一例患者复发。国外文献报道的3例患者均于妊娠期发病并接受手术治疗,国内文献报道的3例患者均于产后接受手术治疗。5例泌乳腺瘤患者行肿物切除术,1例泌乳腺瘤合并乳腺癌患者行乳腺癌改良根治术。术后均无一例患者复发。

结论

泌乳腺瘤是一种罕见的发生于围生期的良性肿瘤,过度按摩等干预易导致其感染。感染化脓后可采取超声引导下细针抽吸冲洗或切开引流治疗后,行肿物切除术根治。

Objective

To investigate the etiology, clinical manifestations and treatment methods of lactating adenoma.

Methods

A total of 11 cases with lactating adenoma were included into this study. Among them, five cases were diagnosed as lactating adenoma in the Center for Prevention and Cure of Breast Disease, Beijing Haidian Maternal and Child Health Hospital From July 1,2004 to March 30,2012, another 6 cases of lactating adenoma were searched from Pubmed and Wanfang Database from July 20th, 1998 to June 21th, 2012. This research followed the process conforms to the mammary gland disease prevention and control center of Beijing Haidian District Maternity and Child Care ethics standards promulgated by the human subjects committee.

Results

Among those 5 cases, one case found breast lumps at gestational age of 17 weeks and underwent breast surgery for neoplasms at gestational age of 25 weeks. Postoperative histopathological examination results showed secrete breast tumor. Two patients underwent breast formed sinus tract and resected. One case was puctured 4 times guiding by the color Doppler ultra sound. After the infection was controlled, breast neoplasm was cutted off. One case was found breast neoplasm during the process of regular breast abscess drainage and underwent resection. The follow-up showed no one had recurrence. Among those 6 cases, three patients reported in literatures abroad showed patients accepted surgery during pregnancy, and another three patients reported in literatures in domestic showed patients underwent postpartum surgery treatment. And five cases underwent neoplasm resection and one case who was combined with breast cancer underwent breast cancer modified radical. No recurrence were found among those six patients.

Conclusions

Lactating adenoma is a rare benign tumor during perinatal period. Excessive intervention such as massage could lead to infection. Infections after maturation can be treated by the incision and drainage, or fine needle aspiration and flush with ultrasound-guided.

表1 本院收治的5例泌乳腺瘤及6例文献报道泌乳腺瘤临床资料及治疗方案
Table 1 Clinical data and treatment programs of 11 cases with lactating adenoma
1
Choudhury M, Singal MK. Lactating adenoma: cytomorphologic study with review of literature [J]. Indian J Pathol Microbiol, 2001, 44(4):445-448.
2
杨宏,周雷,张国超,等.罕见乳腺巨大泌乳性腺瘤一例[J/CD].中华临床医师杂志:电子版,2011,5(22):6849-6850.
3
童彩玲,杨海燕,黄梅,等.泌乳腺瘤1例[J].临床肿瘤学杂志,2009,15(4):384.
4
黄泽春,康强,谭章梅,等.乳房巨大泌乳腺瘤切除整形术一例[J].中华整形外科杂志,2008,24(6):443.
5
Magno S, Terribile D, Franceschini G, et al. Early onset lactating adenoma and the role of breast MRI: a case report[J]. J Med Case Rep, 2009, 3:43.
6
Behrndt VS, Barbakoff D, Askin FB, et al. Infarcted lactating adenoma presenting as a rapidly enlarging breast mass [J]. AJR Am J Roentgenol, 1999, 173(4):933-935.
7
Saglam A, Can B. Coexistence of lactating adenoma and invasive ductal adenocarcinoma of the breast in a pregnant woman[J]. Clin Pathol, 2005, 58(1):87-89.
8
许良中.乳腺病理学[M].上海:上海医科大学出版社,1999:53-54.
9
Lee ES, Kim I. Multiple vulvar lactating adenomas [J]. Obstet Gynecol, 2012, 184(10):934-935.
10
Baker TP, Lenert JT, Parker J, et al. Lactating adenoma: a diagnosis of exclusion[J]. Breast J, 2001, 7(5):354-357.
11
陈立红,俞公煌.1 278例乳腺肿块患者的年龄分析[J].浙江临床医学,2004,6(8):726-727.
12
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13
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14
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15
Darling ML, Smith DN, Rhei E, et al. Lactating adenoma: sonographic features[J]. Breast J, 2000, 6(4):252-256.
16
James K, John B, Peter P, et al. Breast tumour of pregnancy (Lactating adenoma)[J]. Pathol, 1988, 156(10):37-44.
17
Terada S, Uchide K, Suzuki N, et al. A lactating adenoma of the breast[J]. Gynecol Obstet Invest, 1992, 34(2):126-128.
18
Son EJ, Oh KK, Kim EK. Pregnancy-associated breast disease: radiologic features and diagnostic dilemmas[J]. Clin Pathol, 2005, 58(1):87-89.
19
Sumkin JH, Perrone AM, Harris KM, et al. Lactating adenoma: US features and literature review[J]. Radiology, 1998, 206(1):271-274.
20
Magno S, Terribile D, Franceschini G, et al. Breast MRI in a case of "early onset" lactating adenoma[J]. Breast J, 2009, 15(1):105-106.
21
Eid S, Dos Santos E, Boisserie-Lacroix M, et al. Lactating adenoma: radiologic aspects. A case report [J]. Radiol, 2001, 82(3 Pt 1):264-267.
22
Bock K, Duda VF, Hadji P, et al. Sonographic variability of lactating adenoma demonstrated by a longitudinal evaluation of 4 cases[J]. Ultraschall Med, 2001, 22(4):176-181.
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