Zheng Yu, Ding Tingting, Wang Rong
Breast Disease Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
Discov Oncol. 2025 Jun 14;16(1):1101. doi: 10.1007/s12672-025-02855-y.
Breast metastases from pulmonary large-cell neuroendocrine carcinoma (LCNEC) often mimic benign tumors, making diagnosis challenging due to their rarity.
A 49-year-old female presented with bilateral breast masses noticed during self-examination for three weeks. Given the benign appearance of the lesions, same-day en bloc resection was planned without preoperative biopsy. Consequently, the patient underwent bilateral mastectomy and axillary surgery based on intraoperative frozen section results, which suggested a possible primary high-grade invasive breast cancer, but no metastatic workup was performed beforehand. Postoperatively, she was diagnosed with LCNEC, with bilateral breast and multiple systemic metastases, leading to an unnecessary surgery.
Thorough preoperative evaluation is essential for unusual breast tumors to differentiate between primary and secondary lesions. Maybe pulmonary neuroendocrine carcinoma in the lower lobe more commonly metastasizes to the breast through hematogenous spread, while upper lobe lesions typically spread via lymphatic routes.
肺大细胞神经内分泌癌（LCNEC）的乳腺转移瘤常类似良性肿瘤，因其罕见，诊断具有挑战性。
一名49岁女性在自我检查时发现双侧乳腺肿块，持续三周。鉴于病变外观呈良性，计划在未进行术前活检的情况下进行当日整块切除。因此，患者根据术中冰冻切片结果接受了双侧乳房切除术和腋窝手术，冰冻切片结果提示可能为原发性高级别浸润性乳腺癌，但术前未进行转移灶检查。术后，她被诊断为LCNEC，伴有双侧乳腺及多处全身转移，导致了不必要的手术。
对于不寻常的乳腺肿瘤，进行全面的术前评估对于区分原发性和继发性病变至关重要。或许下叶的肺神经内分泌癌更常通过血行播散转移至乳腺，而上叶病变通常通过淋巴途径转移。
