Department of Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Radiology, Faculty of Medicine, Omdurman Islamic University, Omdurman, Sudan.
Am J Case Rep. 2021 Sep 27;22:e932274. doi: 10.12659/AJCR.932274.
BACKGROUND Primary breast small cell neuroendocrine carcinoma is a rare subtype of breast cancer with about 57 cases reported in the literature. This rare type of cancer represents about 0.1% of breast carcinomas. Recently, the World Health Organization defined this type of cancer as a separate entity from other breast cancer types. The diagnosis of this type of cancer in the breast is difficult because the histological pattern is similar to the small cell neuroendocrine carcinoma of other more common primary sites of origin, including the lung. CASE REPORT A 39-year-old woman presented to our hospital with a left breast mass and recurrent mastitis. Physical examination revealed a painless lump in her left breast with a brown-colored discharge from the nipple, and her child refused breastfeeding from the left breast. A high-density well-defined rounded mass was observed upon mammography in the upper lateral aspect of the left breast. This mass lesion appeared hypoechoic with no posterior acoustic shadowing on ultrasound scan. A core-needle biopsy of the mass was performed and the diagnosis of small cell neuroendocrine carcinoma was rendered after histopathologic examination. Positron emission tomography scanning was helpful in the exclusion of primary origin from other organ sites; thus, the primary breast origin of the tumor was confirmed. CONCLUSIONS This case report provides a comprehensive approach to diagnose this type of small cell carcinoma originating primarily in the breast. The suspicion of this type of breast cancer should be raised if there is presence of characteristic histopathologic findings with the exclusion of any primary origin from other organ sites by the help of imaging studies.
原发性乳腺小细胞神经内分泌癌是一种罕见的乳腺癌亚型,文献中报道约有 57 例。这种罕见类型的癌症约占乳腺癌的 0.1%。最近,世界卫生组织将这种类型的癌症定义为与其他乳腺癌类型不同的独立实体。由于组织学模式与其他更常见的起源部位(包括肺)的小细胞神经内分泌癌相似,因此在乳腺中诊断这种类型的癌症具有一定难度。
一名 39 岁女性因左乳肿块和复发性乳腺炎就诊于我院。体格检查发现其左乳有一无痛性肿块,伴有乳头棕色分泌物,其孩子拒绝从左乳哺乳。乳腺 X 线摄影显示左乳上外侧有高密度、边界清楚的圆形肿块。超声扫描显示该肿块病变呈低回声,无后向声影。对肿块进行了空心针活检,组织病理学检查后诊断为小细胞神经内分泌癌。正电子发射断层扫描有助于排除其他器官原发灶;因此,肿瘤的原发性乳腺起源得到了确认。
本病例报告提供了一种全面的方法来诊断这种原发性乳腺小细胞癌。如果存在特征性组织病理学发现,并通过影像学研究排除任何其他器官的原发性起源,则应怀疑这种类型的乳腺癌。