Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report

Abstract Background Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patie...

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Main Authors: Akiko Shimazaki, Takuma Hashimoto, Masaya Kai, Tetsuzo Nakayama, Mai Yamada, Karen Zaguirre, Kentaro Tokuda, Makoto Kubo, Ken Yamaura, Masafumi Nakamura
Format: Article
Language:English
Published: Japan Surgical Society 2021-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-020-01068-5
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author Akiko Shimazaki
Takuma Hashimoto
Masaya Kai
Tetsuzo Nakayama
Mai Yamada
Karen Zaguirre
Kentaro Tokuda
Makoto Kubo
Ken Yamaura
Masafumi Nakamura
author_facet Akiko Shimazaki
Takuma Hashimoto
Masaya Kai
Tetsuzo Nakayama
Mai Yamada
Karen Zaguirre
Kentaro Tokuda
Makoto Kubo
Ken Yamaura
Masafumi Nakamura
author_sort Akiko Shimazaki
collection DOAJ
description Abstract Background Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease. Case presentation The patient was diagnosed with EPP at the age of 33 and had a rich family history of the disease. For right breast cancer initially considered as TisN0M0 (Stage 0), the right mastectomy and sentinel lymph node biopsy were performed, while the final stage was pT1bN0M0, pStage I. In the perioperative period, we limited the drug use and monitored light wavelength measurements. Besides, we covered surgical lights, headlights, and laryngoscope’s light with a special polyimide film that filtered the wavelength of light causing dermal photosensitivity. After the surgery, any emerging complications were closely monitored. Conclusions The surgery, internal medicine, anesthesiology, and operation departments undertook all possible measures through close cooperation to ensure a safe surgery for the patient with a rare condition.
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spelling doaj-art-1d86ff955d414e2989ec2f172d1f548b2025-08-20T02:42:03ZengJapan Surgical SocietySurgical Case Reports2198-77932021-01-01711610.1186/s40792-020-01068-5Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case reportAkiko Shimazaki0Takuma Hashimoto1Masaya Kai2Tetsuzo Nakayama3Mai Yamada4Karen Zaguirre5Kentaro Tokuda6Makoto Kubo7Ken Yamaura8Masafumi Nakamura9Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityOperating Room, Kyushu University HospitalDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityEmergency and Critical Care Center, Kyushu University HospitalDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityAbstract Background Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease. Case presentation The patient was diagnosed with EPP at the age of 33 and had a rich family history of the disease. For right breast cancer initially considered as TisN0M0 (Stage 0), the right mastectomy and sentinel lymph node biopsy were performed, while the final stage was pT1bN0M0, pStage I. In the perioperative period, we limited the drug use and monitored light wavelength measurements. Besides, we covered surgical lights, headlights, and laryngoscope’s light with a special polyimide film that filtered the wavelength of light causing dermal photosensitivity. After the surgery, any emerging complications were closely monitored. Conclusions The surgery, internal medicine, anesthesiology, and operation departments undertook all possible measures through close cooperation to ensure a safe surgery for the patient with a rare condition.https://doi.org/10.1186/s40792-020-01068-5Erythropoietic protoporphyria (EPP)PhotosensitivityBreast cancer surgery
spellingShingle Akiko Shimazaki
Takuma Hashimoto
Masaya Kai
Tetsuzo Nakayama
Mai Yamada
Karen Zaguirre
Kentaro Tokuda
Makoto Kubo
Ken Yamaura
Masafumi Nakamura
Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
Surgical Case Reports
Erythropoietic protoporphyria (EPP)
Photosensitivity
Breast cancer surgery
title Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
title_full Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
title_fullStr Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
title_full_unstemmed Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
title_short Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
title_sort surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity a case report
topic Erythropoietic protoporphyria (EPP)
Photosensitivity
Breast cancer surgery
url https://doi.org/10.1186/s40792-020-01068-5
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