Alqaisi Sura, Rahman Ali, Barnes Martin, LiPera William, Kaell Alan T
Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Port Jefferson, USA.
Internal Medicine, Mather Hospital at Northwell Health, Port Jefferson, USA.
Cureus. 2022 Mar 18;14(3):e23302. doi: 10.7759/cureus.23302. eCollection 2022 Mar.
Neuroendocrine neoplasms (NENs) are epithelial neoplasms with predominant neuroendocrine differentiation that arise in the gastrointestinal tract, unique to the site of origin, such as the pancreas and small intestine. Neuroendocrine breast carcinoma (NEBC) is a rare tumor. Diagnosing NEBC is challenging because there is no specific clinical presentation, as it is usually presented as a breast lump. Therefore, diagnosing NEBC before biopsy is difficult. Another challenge in diagnosing NEBC is to know whether it is primary or metastatic. We present a case of a 60-year-old woman found to have a solid left breast nodule during routine screening mammography. Tissue biopsy was found to be consistent with metastatic NEBC. The patient was found to have primary small intestine asymptomatic NENs on further diagnostic tests. Eventually, she had a lumpectomy and started on lanreotide (Somatuline) intramuscular monthly injections. As per literature, metastatic NEBC is infrequent. It was considered a poor prognostic breast tumor, as it is usually presented as hormonally negative breast cancer. Management of metastatic versus primary NEBC is still more controversial. Gastroenteropancreatic NENs are treated with long-acting somatostatin analogs with good prognostic results.
神经内分泌肿瘤（NENs）是一种上皮性肿瘤，具有主要的神经内分泌分化，起源于胃肠道，在胰腺和小肠等特定起源部位较为独特。神经内分泌乳腺癌（NEBC）是一种罕见肿瘤。诊断NEBC具有挑战性，因为它没有特异性临床表现，通常表现为乳腺肿块。因此，在活检前诊断NEBC很困难。诊断NEBC的另一个挑战是确定它是原发性还是转移性。我们报告一例60岁女性，在常规乳腺钼靶筛查中发现左乳实性结节。组织活检结果与转移性NEBC一致。进一步诊断检查发现该患者患有原发性小肠无症状NENs。最终，她接受了肿块切除术，并开始每月肌肉注射兰瑞肽（索马杜林）。根据文献，转移性NEBC并不常见。它被认为是一种预后较差的乳腺肿瘤，因为它通常表现为激素受体阴性乳腺癌。转移性与原发性NEBC的治疗仍存在更多争议。胃肠胰腺NENs采用长效生长抑素类似物治疗，预后良好。
