[A Case of Long-Term Survival Achieved by Aggressive Surgical Treatment for Late Recurrence Following Initial Surgery for Breast Cancer].

We herein report a patient with postoperative late recurrence ofbreast cancer that was resistant to systemic therapy who achieved long-term survival after aggressive surgical treatment. A 53-year-old woman underwent modified muscle-preserving radical mastectomy for right breast cancer in May 1999. Adjuvant therapy with oral anticancer agents and an antiestrogen were initiated. Since the patient was recurrence free for 5 years postoperatively, only the administration of antiestrogen was continued. In November 2007, the administration oforal anticancer agents was resumed on the suspicion ofmetastasis to the right supraclavicular node. Although cyclophosphamide, epirubicin, and 5-fluorouracil(CEF)therapy plus an oral aromatase inhibitor was initiated in February 2008, lymph node enlargement was noted. As other forms of chemotherapy did not produce a favorable response, the patient underwent cervical lymphadenectomy in December 2009. As repeated recurrences were observed thereafter, surgical excisions of the right cervical mass were performed in January, March, and April 2010. In December 2013, right cervical lymphadenectomy was performed. Histological findings of all the excised specimens were consistent with breast cancer metastasis. Since then, the patient has been well without recurrence, although she continues to receive aromatase inhibitor treatment.

[Peritoneal Cancer Resected as a Greater Omentum Mass-Report of a Patient Surviving Long Term without Recurrence].

We present an interesting case in which a patient diagnosed with primary peritoneal cancer after the resection of a greater omentum mass achieved recurrence-free survival without postoperative systemic chemotherapy. The patient was a 78-yearold woman with no history ofmalignant disease. She underwent abdominal ultrasound at a local clinic, which revealed a mass shadow near the descending colon. She was referred to us in May 2014. Contrast-enhanced abdominal computed tomography showed a homogeneously enhanced soft-tissue mass measuring 94×80×34mm in size in the left lower abdomen, which did not connect to the gastrointestinal tract. In June 2014, a gastrointestinal stromal tumor was suspected, and laparotomy was performed. Laparotomy findings suggested a tumor originating from the greater omentum and no evidence of perifocal invasion. The tumor was resected with the surrounding greater omentum. Pathological examination revealed very poorly differentiated adenocarcinoma, also consistent with ovarian serous adenocarcinoma. No lesions were detected in any other organs by pre- and postoperative examinations, and the patient was diagnosed with primary peritoneal cancer. As the patient refused to receive postoperative systemic chemotherapy, we decided to continue with follow-up only. The patient was alive without recurrence as ofApril 2018.