An effective 5-fluorouracil, levofolinate, and oxaliplatin therapy for recurrent breast cancer: a case report

Abstract

Introduction: Therapy comprising 5-fluorouracil, levofolinate, and oxaliplatin is currently the most common chemotherapy for colorectal cancer. We experienced a successful case of advanced colon cancer and recurrent breast cancer with 5-fluorouracil, levofolinate, and oxaliplatin therapy.

Case presentation: A 43-year-old Japanese woman who had already undergone surgery three times for bilateral breast cancer was admitted to our hospital for the treatment of advanced transverse colon cancer. Preoperative computed tomography demonstrated a swollen lymph node at her right upper clavicle, and fine-needle aspiration biopsy of the lymph node showed that it was a metastasis from the breast cancer. A laparoscopic-assisted colectomy was performed and the pathology demonstrated that the final stage was IIIC (T4aN2aM0, Union for International Cancer Control, 7th edition). The pathological findings and immunohistochemistry showed that the transverse colon tumor was not a metastatic lesion from the breast cancer, but was a de novo colon cancer. Chemotherapy was necessary for both the recurrent breast cancer and the Stage IIIC colon cancer. Therapy of 5-fluorouracil, levofolinate, and oxaliplatin was administered; the therapy included 5-fluorouracil, which is considered to be effective for both colon and breast cancer. After two courses of 5-fluorouracil, levofolinate, and oxaliplatin, the lymph node began to shrink and almost completely disappeared after eight courses of 5-fluorouracil, levofolinate, and oxaliplatin.

Conclusion: We surmise that 5-fluorouracil, levofolinate, and oxaliplatin have the potential to provide a good response for tumors that are sensitive to fluorinated pyrimidine and platinum-containing anticancer drugs such as breast cancer.

Figure 1

Colonoscopy shows a tumor lesion with severe stenosis at the transverse colon.

Figure 2

Barium enema shows an apple core sign at the transverse colon.

Figure 3

Cervical computed tomography demonstrates a swollen supraclavicular lymph node. The size decreased from 20mm (a: arrow) to 5mm (b: arrow) after FOLFOX.

Figure 4

Positron emission tomography scan. (a) Positron emission tomography scan shows some ¹⁸F-fluorodeoxyglucose uptake in lesions at the supraclavicular region and parasternal region. (b) However, these lesions vanished completely after 5-fluorouracil, levofolinate, and oxaliplatin.

Figure 5

Macroscopic finding of resected specimen shows the diffuse invasive type, 50×42mm in size.