SUCCESSFUL TREATMENT BY RADIATION AND HORMONE-THERAPY OF ISOLATED LOCAL RECURRENCE OF BREAST-CANCER 24 YEARS AFTER MASTECTOMY ACCOMPANIED BY IMMUNE THROMBOCYTOPENIA - A CASE-REPORT

We report a case of isolated local recurrence of breast cancer, which was accompanied by idiopathic thrombocytopenic purpura (ITP) and benig n monoclonal gammopathy that presented 24 years after the patient unde rwent mastectomy A 72-year-old female patient with a chest wall tumor was referred to our hospital in November 1994, Twenty-four years previ ously she had surgically treated breast cancer, of which the pathology was scirrhous carcinoma. Needle biopsy of the tumor revealed tubular carcinoma, which is compatible with local recurrence of breast cancer. She had no evidence of regional lymph node involvement or distant met astasis. Hematological and serological examination revealed a low plat elet count accompanied by M-proteinemia (IgG, Ic-type) and a mild incr ease in platelet-associated IgG, She was initially treated with extens ive-field chest wall radiation (60 Gy), followed by systemic administr ation of tamoxifen, Complete local control of isolated local recurrenc e (LR) was achieved after radiation therapy (RT) and the patient has b een progression-free for more than 2 years. Platelet count recovered g radually to a normal level after achievement of complete remission ind uced by radiation and tamoxifen. This may be the first case suggestive of a paraneoplastic syndrome of immune thrombocytopenia accompanied b y local recurrence of breast cancer.