Breast Carcinoma with Neuroendocrine Differentiation and Myocardial Metastases

ArticleinClinical Breast Cancer 7(11):892-4 · January 2008with6 Reads
DOI: 10.3816/CBC.2007.n.056 · Source: PubMed
Abstract
A 63-year-old Japanese woman was diagnosed with metastatic well-differentiated neuroendocrine carcinoma presenting as a perianal mass without an obvious primary site. Two years later, she presented with a breast mass determined on histologic examination to be the primary neuroendocrine carcinoma. The tumor was weakly positive for estrogen receptor and clearly originated in multifocal ductal carcinoma in situ. At the same time, she was found to have multiple metastases in bone and liver and, later, heart. Most studies report a relatively poor prognosis and limited treatment responsiveness for neuroendocrine breast carcinoma. Better understanding of the cellular origin and molecular pathogenesis of this relatively enigmatic rare disease is required.
  • [Show abstract] [Hide abstract] ABSTRACT: [Objective] To study the features of the clinical diagnosis and treatment of neuroendocrine carcinoma of the breast. [Methods] Three patients with breast neuroendocrine carcinoma were admitted from January 1990 to March 2009 in Aviation Central Hospital of China. Their clinical and pathological data, treatment and prognosis were analyzed retrospectively. [Results] All the three lesions were palpable, painless and were found by the patients themselves. Molybdenum target film showed no calcification and sentus in any of the three lesions. Ultrasound image presented circumscribed masses with heterogeneously hypoecho, distinct boundary and abundant vascularity. All the patients were diagnosed neuroendocrine carcinoma pathologically. Immunohistochemical results showed Syn(+ +) in 1 case, Syn(+ + +) in 2 cases, CgA(+ +) in 3 cases and NSE(+) in 1 case, NSE(+ +) in 2 cases; Her - 2 was negative in the 3 patients. The 3 patients were followed up for 15 to 96 months. One patient with no lymph node metastasis was still alive without relapse and metastasis 96 months after the treatment. There were two patients with lymph node metastasis. Multiple metastasis were revealed in 1 patients with lymph node metastasis in 12 months after operation and died in 15 months after excision. Bone metastasis was seen in another patient with lymph node metastasis in 36 months after operation and had survived for 60 months after excision. [Conclusion] Neuroendocrine carcinoma is a rare malignant tumor of the breast. No calcification and sentus, heterogeneously hypoecho, distinct boundary, abundant vascularity and negative expression of Her - 2 might be the characteristics of the disease. Diagnosis of this disease should only depend on pathological and immunohistochemical results, neuroendocrine carcinoma of the breast may have no difference from other clinical well - informed breast cancers. Prognosis of the disease is correlated with its pathological types and clinical TNM - Staging.
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  • [Show abstract] [Hide abstract] ABSTRACT: Objective: To study the clinicopathologic features and prognosis of breast neuroendocrine carcinoma (NEC). Methods: Thirty-two breast NEC patients were admitted between January 2003 and July 2010 to Tianjin Medical University Cancer Institute and Hospital. Their clinicopathologic data, treatment, and prognosis were retrospectively analyzed. Results: All of the 32 patients were females aged 36 years to 76 years (mean of 58.3 years), all 32 carcinomas were palpable, painless, and detected by the patients themselves. All cases were pathologically diagnosed as NEC. The immunohistochemical results showed that the positive rates for synaptophysin, NSE , and chromogranin A were 54.5% (6/11), 83.3% (20/24), and 93.75% (30/32), respectively. Twenty-seven cases were positive for ER, 22 for PR, 3 for C-erbB-2, and 6 for P53. All patients survived and were followed up for 7 to 91 months (mean of 30 months) except for one who died because of systemic multiple metastases. A positive correlation was observed between ER and PR ( P < 0.01), and the positive rates for ER and PR were quite high. Moreover, both ER and PR were negatively correlated with P53 (P < 0.01 and P < 0.05, respectively) and had low positive expression. A significant difference was observed between the breast NEC simplex and complex in TNM staging (P < 0.05). All of the 13 cases of breast NEC complex had high TNM staging, whereas none of the 19 cases of breast NEC simplex had high TNM staging. Conclusion: Breast NEC is a rare and distinct category with different histological subtypes. The diagnosis of this disease should depend on the neuroendocrine markers detected by immunohistochemistry. The combined treatment is valuable for improving the overall and disease-free survival rates. Breast NEC is mostly ER and/or PR dependent and can be treated with endocrine therapy. Breast NEC simplex has relatively low TNM staging and will not easily transfer to the lymph nodes, indicating a good prognosis. Larger samples and longer follow-up periods are needed to investigate the biological characteristics and prognosis of NEC.
    Article · Jan 2012 · Molecular Cancer Therapeutics
    Y. ZhangY. ZhangL. QiL. QiL. FuL. Fu+1 more author ...L. GuL. Gu
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