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Small cell neuroendocrine tumor of the breast in a 40 year-old woman: a case report.

Nicoletti S, Papi M, Drudi F, Fantini M, Canuti D, Tamburini E, Possenti C, Pasquini E, Brisigotti M, Ravaioli A - J Med Case Rep (2010)

Bottom Line: A correct treatment needs to be chosen.Our patient is alive and well without disease eight years after treatment.We performed an adjuvant therapy with the classic scheme doxorubicin and cyclophosphamide, followed by carboplatin and etoposide.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology and Oncoematology Department, 'Infermi' Hospital, Via Settembrini 2, Rimini, 47921 Italy. aravaiol@auslrn.net.

ABSTRACT

Introduction: Small cell neuroendocrine cancer of the breast is a rare tumor with less than 30 cases reported in the literature. The morphological and immunohistochemical patterns of this tumor are similar to small cell neuroendocrine cancer of the lung. For this reason, it is often difficult to distinguish a primary small cell neuroendocrine cancer of the breast from a metastatic lesion from other sites.

Case presentation: We report and characterize with immunohistochemical techniques a case of primary small cell neuroendocrine cancer of the breast occurring in a 40-year-old Caucasian woman. A palpable and mobile 3.0 cm tumor was located in the upper-outer quadrant of her right breast. Lumpectomy and subsequent radical mastectomy with axillary lymph node resection were performed. Microscopically, the tumor consisted predominantly of a diffuse proliferation of small oat cells. The tumor cells were positive for neuroendocrine markers chromogranin A and synaptophysin. One of 16 lymph nodes was metastatic. A correct treatment needs to be chosen.

Conclusions: It has recently been demonstrated that early small cell neuroendocrine cancer of the breast shows a good prognosis with adjuvant treatments with high disease free survival. Our patient is alive and well without disease eight years after treatment. We performed an adjuvant therapy with the classic scheme doxorubicin and cyclophosphamide, followed by carboplatin and etoposide. A more extensive review is required to define a standard treatment protocol for this rare neoplasm.

No MeSH data available.


Related in: MedlinePlus

Histopathologic characteristics of the tumor.
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Figure 1: Histopathologic characteristics of the tumor.

Mentions: In February 2000, a 40-year-old Caucasian woman developed a palpable mobile node in her right breast, 3.0 cm in diameter. The mass was located in the upper-outer quadrant of her right breast. Mammography and ecography revealed the nodule to have suspicious characteristics. The biopsy of the lump revealed a SCNC of the breast. The personal history of our patient was characterized by first degree family history of breast cancer. Her mother was diagnosed with breast cancer at 57 years old and her mother's aunt with SCNC of the lung at 73 years of age. At the time of evaluation, our patient was in good general condition, without other co-morbidities. She was treated with mastectomy and axillary lymph node resection. Our patient was in good health with a Performance Status 0 (ECOG), with negative routine laboratory investigations, normal serum breast cancer markers and chromogranin of 45 ng/mL. A thorough examination (abdominal ultrasound, total-body computerized tomography, bone scintigraphy, pelvic and transvaginal ultrasound) showed no evidence of metastases. Macroscopically, the tumor was 3 cm in maximum diameter (pT2). It was yellowish-white with large areas of coagulative necrosis, ductal hyperplasia and fibrous parenchyma. Widespread vascular invasion was present. One of 16 lymph nodes was metastatic (pN1a). Microscopically, the tumor was characterized by atypical cells with dimorphic nuclei and scant cytoplasm, organized in solid and trabecular arrangements. Widespread necrosis was present. The tumor cells were highly positive for neuron specific enolase (NSE), chromogranin and synaptophysin and negative for c-erb-B2 and cytocheratin 20 (Figure 1). Estrogen receptors were positive in 80% of the tumor cells, progesterone receptors were positive in 90%, Ki-67 90%, c-erb-B2 absent, p53 90%. No ductal carcinoma in situ was observed. For this reason, we obtained two separate revisions of the samples, one by the Pathology Department of "M. Malpighi" Hospital in Bologna and one by the Pathology Department of the Oncologic Institute in Milan (IEO) confirmed the diagnosis.


Small cell neuroendocrine tumor of the breast in a 40 year-old woman: a case report.

Nicoletti S, Papi M, Drudi F, Fantini M, Canuti D, Tamburini E, Possenti C, Pasquini E, Brisigotti M, Ravaioli A - J Med Case Rep (2010)

Histopathologic characteristics of the tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2913980&req=5

Figure 1: Histopathologic characteristics of the tumor.
Mentions: In February 2000, a 40-year-old Caucasian woman developed a palpable mobile node in her right breast, 3.0 cm in diameter. The mass was located in the upper-outer quadrant of her right breast. Mammography and ecography revealed the nodule to have suspicious characteristics. The biopsy of the lump revealed a SCNC of the breast. The personal history of our patient was characterized by first degree family history of breast cancer. Her mother was diagnosed with breast cancer at 57 years old and her mother's aunt with SCNC of the lung at 73 years of age. At the time of evaluation, our patient was in good general condition, without other co-morbidities. She was treated with mastectomy and axillary lymph node resection. Our patient was in good health with a Performance Status 0 (ECOG), with negative routine laboratory investigations, normal serum breast cancer markers and chromogranin of 45 ng/mL. A thorough examination (abdominal ultrasound, total-body computerized tomography, bone scintigraphy, pelvic and transvaginal ultrasound) showed no evidence of metastases. Macroscopically, the tumor was 3 cm in maximum diameter (pT2). It was yellowish-white with large areas of coagulative necrosis, ductal hyperplasia and fibrous parenchyma. Widespread vascular invasion was present. One of 16 lymph nodes was metastatic (pN1a). Microscopically, the tumor was characterized by atypical cells with dimorphic nuclei and scant cytoplasm, organized in solid and trabecular arrangements. Widespread necrosis was present. The tumor cells were highly positive for neuron specific enolase (NSE), chromogranin and synaptophysin and negative for c-erb-B2 and cytocheratin 20 (Figure 1). Estrogen receptors were positive in 80% of the tumor cells, progesterone receptors were positive in 90%, Ki-67 90%, c-erb-B2 absent, p53 90%. No ductal carcinoma in situ was observed. For this reason, we obtained two separate revisions of the samples, one by the Pathology Department of "M. Malpighi" Hospital in Bologna and one by the Pathology Department of the Oncologic Institute in Milan (IEO) confirmed the diagnosis.

Bottom Line: A correct treatment needs to be chosen.Our patient is alive and well without disease eight years after treatment.We performed an adjuvant therapy with the classic scheme doxorubicin and cyclophosphamide, followed by carboplatin and etoposide.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology and Oncoematology Department, 'Infermi' Hospital, Via Settembrini 2, Rimini, 47921 Italy. aravaiol@auslrn.net.

ABSTRACT

Introduction: Small cell neuroendocrine cancer of the breast is a rare tumor with less than 30 cases reported in the literature. The morphological and immunohistochemical patterns of this tumor are similar to small cell neuroendocrine cancer of the lung. For this reason, it is often difficult to distinguish a primary small cell neuroendocrine cancer of the breast from a metastatic lesion from other sites.

Case presentation: We report and characterize with immunohistochemical techniques a case of primary small cell neuroendocrine cancer of the breast occurring in a 40-year-old Caucasian woman. A palpable and mobile 3.0 cm tumor was located in the upper-outer quadrant of her right breast. Lumpectomy and subsequent radical mastectomy with axillary lymph node resection were performed. Microscopically, the tumor consisted predominantly of a diffuse proliferation of small oat cells. The tumor cells were positive for neuroendocrine markers chromogranin A and synaptophysin. One of 16 lymph nodes was metastatic. A correct treatment needs to be chosen.

Conclusions: It has recently been demonstrated that early small cell neuroendocrine cancer of the breast shows a good prognosis with adjuvant treatments with high disease free survival. Our patient is alive and well without disease eight years after treatment. We performed an adjuvant therapy with the classic scheme doxorubicin and cyclophosphamide, followed by carboplatin and etoposide. A more extensive review is required to define a standard treatment protocol for this rare neoplasm.

No MeSH data available.


Related in: MedlinePlus