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Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report.

ABSTRACT: Background:Metastatic neuroendocrine tumours (NETs) to the breast are very rare entities. Case presentation:A 26-year-old lady presented with anterior neck swelling with symptoms of superior vena cava syndrome for 6 months. Imaging study revealed a mediastinal mass which was preceded with core biopsy which was consistent with high-grade small cell NETs. Despite second-line adjuvant chemotherapy and radiotherapy, her disease became advanced which was confirmed via restaging scan. There were bilateral breast lesions discovered during the scan which was deemed to be metastatic NETs histologically. Despite prompt initiation of treatment, she succumbed 1 year after the radiotherapy due to disease progression. Conclusion:High suspicion of an index is needed for diagnosis when patients with known primary NETs present with suspicious breast lesions. Triple assessment is mandatory, however histopathology assessment and immunohistochemistry staining are the mainstay of diagnosis.

SUBMITTER: Chan KH

PROVIDER: S-EPMC7683178 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report.

Chan Kheng Hooi KH Lee Chang Haur CH Sharif Siti Zubaidah SZ Hayati Firdaus F Sallapan Sugunah S

Annals of medicine and surgery (2012) 20201111

<h4>Background</h4>Metastatic neuroendocrine tumours (NETs) to the breast are very rare entities.<h4>Case presentation</h4>A 26-year-old lady presented with anterior neck swelling with symptoms of superior vena cava syndrome for 6 months. Imaging study revealed a mediastinal mass which was preceded with core biopsy which was consistent with high-grade small cell NETs. Despite second-line adjuvant chemotherapy and radiotherapy, her disease became advanced which was confirmed via restaging scan. T ...[more]

PMID: 33251002

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Project description:BackgroundLaryngeal neuroendocrine tumors (NETs) represent less than 1% of all malignancies originating from the larynx and available data are limited on case reports. Calcitonin secreting laryngeal NETs are extremely rare and serial dosing of calcitonin in these patients might reveal early relapse or persistence.Case descriptionWe report the case of a 71-year-old woman with persistent pharyngodynia who underwent surgery for an initial diagnosis of small cell undifferentiated neuroendocrine carcinoma (SCUNC) of the larynx (on the epiglottis extended to the left glosso-epiglottic vallecula). The immunohistochemical profile showed the presence of synaptophysin, neuron-specific enolase (NSE), chromogranin A, pan-cytokeratin, including cytokeratin AE1-AE2, and focally calcitonin. The circulating NSE was 13.4 microg/L (normal level <12.5 microg/L) and the basal serum level of calcitonin was 237 pg/mL (normal level <11.5 pg/mL). The patient was started on first-line carboplatin-etoposide chemotherapy because of early relapse to an axillary lymph node. After 4 cycles of treatment, a radiological stability and metabolic response were demonstrated together with a drastic decrease of circulating serum level of calcitonin (from 237 to 57.9 pg/mL). During the follow up, locoregional relapse of disease occurred, associated with an increase of serum calcitonin (89.3 pg/mL). Disease further progressed on and rechallenge with platinum-etoposide chemotherapy was administered, during which clinical progression was confirmed. Due to the lack of response, a revision of the histology was performed and concluded for a definitive diagnosis of moderately differentiated G2 NET, with a Ki-67 index of 22.6%.ConclusionsThis is the eighth case report of laryngeal NET, highlighting the challenge in pathological differential diagnosis and therapeutic strategies. The association with elevated serum calcitonin and the trend of this parameter during clinical progression suggest a role of this marker in the diagnosis and early identification of recurrent laryngeal NETs.

Dataset Information

Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report.

Publications

Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report.

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