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肺神经内分泌肿瘤(小细胞肺癌)同步双侧乳腺转移的罕见病例:一例报告及文献复习

The rare case of synchronous bilateral breast metastasis from a lung neuroendocrine tumor (small cell lung carcinoma): a case report and literature review.

作者信息

Shimo Ayaka, Tsugawa Koichiro, Sakamaki Kaori, Kitajima Mina, Takishita Mariko, Tazo Mizuho, Nakano Mari, Kuroda Takako, Motoyoshi Ai, Tsuzuki Makiko, Nishikawa Toru, Kawamoto Hisanori, Doi Masatomo

机构信息

Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, 1-30-37, Syukugawara, Tama, Kawasaki, Kanagawa, 214-0021, Japan.

Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.

出版信息

Surg Case Rep. 2024 Sep 18;10(1):218. doi: 10.1186/s40792-024-01877-y.

Abstract

BACKGROUND

Breast metastasis from small cell neuroendocrine carcinoma (SNEC) is very rare. In the present report, we describe a case of a female patient who was initially diagnosed with triple negative primary bilateral breast cancer, but during systemic examination, the diagnosis was bilateral breast metastasis from SNEC.

CASE PRESENTATION

A 62-year-old woman with no history of smoking presented to the Department of General Medicine with left-sided chest pain, and computed tomography revealed masses in both breasts and left pleural thickening that was further confirmed by mammography and ultrasound of the breasts. A needle biopsy was performed, and triple negative primary bilateral breast cancer was diagnosed. Because progastrin-releasing peptide (ProGRP) 37,300 pg/ml (normal range, 0-81.0 pg/ml) and neuron-specific enolase 35.0 ng/ml (normal range, 0-16.3 ng/ml) levels were elevated, thoracoscopic biopsy was performed, and SNEC was diagnosed. Pathological examinations showed that the bilateral breast masses were also positive for immunohistochemical staining of chromogranin A, synaptophysin, and CD56, leading to a diagnosis of bilateral breast metastasis of neuroendocrine tumor.

CONCLUSION

Although very rare, the possibility of breast metastasis should be considered when malignancy is suspected in other organs.

摘要

背景

小细胞神经内分泌癌(SNEC)发生乳腺转移非常罕见。在本报告中,我们描述了一例女性患者,最初被诊断为三阴性原发性双侧乳腺癌,但在全身检查期间,诊断为SNEC双侧乳腺转移。

病例介绍

一名62岁无吸烟史的女性因左侧胸痛就诊于普通内科,计算机断层扫描显示双侧乳房有肿块以及左侧胸膜增厚,乳房钼靶摄影和超声检查进一步证实了这一情况。进行了针吸活检,诊断为三阴性原发性双侧乳腺癌。由于胃泌素释放肽前体(ProGRP)水平为37300 pg/ml(正常范围为0 - 81.0 pg/ml),神经元特异性烯醇化酶水平为35.0 ng/ml(正常范围为0 - 16.3 ng/ml)升高,遂进行了胸腔镜活检,诊断为SNEC。病理检查显示双侧乳房肿块嗜铬粒蛋白A、突触素和CD56免疫组化染色也呈阳性,从而诊断为神经内分泌肿瘤双侧乳腺转移。

结论

尽管非常罕见,但当怀疑其他器官存在恶性肿瘤时,应考虑乳腺转移的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a50c/11411020/eb4124bcc160/40792_2024_1877_Fig1_HTML.jpg

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