A 52-year-old woman aged 42 years had undergone breast-conserving surgery after preoperative drug therapy (Fluorouracil/Epirubicin/Cyclophosphamide followed by eight courses of Docetaxel) for luminal HER2-type cancer in the left breast, with the chemotherapeutic grade classified as ypT1aN0M0 (ypStageIA). She underwent postoperative adjuvant hormone therapy (tamoxifen for 5 years and a luteinizing hormone releasing hormone derivative for 2 years) and anti-HER2 therapy (trastuzumab for 1 year) and was being followed up. A 10-mm nodule appeared in the upper lobe of her right lung on computed tomography at her 10-year follow-up examination, which was considered to be breast cancer metastasis. Partial lung resection was performed using thoracoscopy to confirm the diagnosis. Positron emission tomography showed a mass lesion with a standardized uptake value of 4.6 in the right retroperitoneum and upper pelvis, and the urologist resected the right renal ureter on suspicion of retroperitoneal tumor invasion. A diagnosis of metastatic lung tumor of retroperitoneal origin was made. Based on this case, when we suspect a solitary metastatic pulmonary nodule, we should also keep in mind that the nodule may have metastasized from an unexpected tumor.
"},{"@language":"ja","@value":"症例は52歳，女性．42歳時に左乳癌に対し，術前薬物療法後に乳房温存手術を施行しypT1aN0M0（ypStageIA）であった．術後補助療法としてホルモン療法＋抗HER2療法を施行後，経過観察中であった．10年目検査のCTで右肺上葉に10 mm大の小結節が出現し乳癌転移と考え，確定診断のため胸腔鏡補助下に肺部分切除を施行し平滑筋肉腫の診断であった．その後のPET検査で右後腹膜，骨盤上部にSUV max 4.6の腫瘤性病変を認め，後腹膜腫瘍疑いで後腹膜腫瘍・右腎尿管切除術を施行し，肺と同様の病理診断であった．以上より後腹膜平滑筋肉腫原発転移性肺腫瘍の診断となった．本症例より，転移性の孤立性肺結節を疑った際に，想定外の腫瘍からの転移も念頭におくべきである．
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