ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Palliative radical transmediastinal interscapulothoracic amputation for breast carcinoma: a case report
Bahadır Çetin1, Hüseyin Çakmak2, Sabahattin Aslan1, Melih Akıncı1, Abdullah Çetin1
1Ankara Onkoloji Eğitim ve Araştırma Hastanesi, 1. Genel Cerrahi Kliniği, Ankara
2Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, Ankara
Scapulothoracic amputation (forequarter amputation) is used for curative or palliative treatment in tumors invading the shoulder girdle and scapular region. Transmediastinal technique was described for tumors invading the thorax and shoulder joint. A 45-year-old premenopausal woman was admitted with a 3x4-cm mass in the left breast causing edema and peau d’orange appearance and a 5x4-cm semifixed lymphadenopathy in axilla. Histopathologic diagnosis was made as invasive ductal carcinoma containing epidermoid components (metaplastic carcinoma). Despite chemotherapy and radiotherapy, the progression of the tumor continued, invading the thoracic wall, axillary artery and vein, and resulting in lung metastasis. Scapulothoracic resection was planned for palliative support. At surgery, it was noted that the tumor invaded the third and fourth ribs, and there was a metastatic mass, 2 cm in size, in the lower lobe of the left lung. An en bloc resection of the mass was performed with wide margins, including the third to fifth ribs, thoracic wall, scapula, and the left arm and the mass in the left lung were removed with wedge resection. Control examinations in the postoperative fourth month showed multiple lung metastases. The patient died in the seventh month due to cardiopulmonary failure secondary to lung metastasis.
Keywords : Amputation/methods; breast neoplasms; neoplasm recurrence, local; scapula/surgery; thoracic surgery/methods
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