Papalampros Alexandros, Mpaili Eustratia, Moris Demetrios, Sarlanis Helen, Tsoli Marina, Felekouras Evangelos, Trafalis Dimitrios T, Kontos Michael
1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Surgery, Duke University Medical Center, Duke University, Durham, NC.
Medicine (Baltimore). 2019 Apr;98(16):e14989. doi: 10.1097/MD.0000000000014989.
Metastatic neuroendocrine neoplasms (NENs) to the breast are very rare entities comprising only 1% to 2% of all metastatic breast tumors. In this article, we describe a case of a neuroendocrine ileal neoplasm metastatic to breast and liver, with breast metastatic tumor to be the initial manifestation of the disease.
We herein report a rare case of a female patient admitted to our department with a palpable painful mass on her left breast.
The surgical and histological investigation revealed a metastatic neuroendocrine neoplasm to the breast originated from terminal ileum.
A left lumpectomy, right hemicolectomy, cholecystectomy, left hepatectomy along with liver metastasectomies (V, VI, VIII) plus radiofrequency ablation of lesions to the right liver lobe plus standard lymphadenectomy was performed.
Considering the advanced stage of the disease, the patient received an adjuvant therapy of somatostatin analog plus everolimus. Under the guidance of oncological consultation, patients follow-up with CT and MRI scan and clinical re-evaluations in the first 3 and 6 months, substantiates no evidence of recurrence and she presents herself asymptomatic.
An appropriate level of suspicion and selective immunohistochemistry in these cases, particularly where no prior history of a known primary neuroendocrine neoplasm occurs, may help to diagnose a previously undetected neuroendocrine tumor elsewhere in the body and provide guidance for the appropriate treatment selection.
转移性神经内分泌肿瘤（NENs）转移至乳腺是非常罕见的情况，仅占所有转移性乳腺肿瘤的1%至2%。在本文中，我们描述了一例神经内分泌性回肠肿瘤转移至乳腺和肝脏的病例，其中乳腺转移瘤是该疾病的首发表现。
我们在此报告一例罕见病例，一名女性患者因左乳可触及疼痛性肿块入住我科。
手术及组织学检查显示，乳腺的转移性神经内分泌肿瘤起源于回肠末端。
进行了左乳肿块切除术、右半结肠切除术、胆囊切除术、左肝切除术及肝转移瘤切除术（V、VI、VIII段），同时对右肝叶病变进行射频消融，并进行标准淋巴结清扫术。
考虑到疾病的晚期阶段，患者接受了生长抑素类似物加依维莫司的辅助治疗。在肿瘤学会诊的指导下，患者在最初3个月和6个月进行了CT和MRI扫描及临床重新评估，结果显示无复发迹象，且患者无症状。
在这些病例中，尤其是在没有已知原发性神经内分泌肿瘤既往史的情况下，保持适当的怀疑程度并进行选择性免疫组化，可能有助于诊断身体其他部位先前未被发现的神经内分泌肿瘤，并为适当的治疗选择提供指导。
