Small cell neuroendocrine carcinoma of the breast: A report of three cases and review of literature

Department of Histopathology, University College Hospital, Galway, Republic of Ireland.
Journal of Clinical Pathology (Impact Factor: 2.92). 08/2005; 58(7):775-8. DOI: 10.1136/jcp.2004.020792
Source: PubMed


Small cell neuroendocrine carcinoma of the breast is a rare tumour with less than 30 cases reported in the literature. The clinicopathological findings of three cases of primary neuroendocrine carcinoma of the breast and a review of the pertinent literature are presented. The morphological and immunohistochemical patterns of this tumour are similar to its pulmonary counterpart. Expression of neuroendocrine markers is inconsistent, so morphology is the mainstay of diagnosis. Size is a very important prognostic factor in this tumour, as in breast carcinomas of the usual type.

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    • "Unlike the SCNC in the lung which is more common in male patients, the incidence of SCNC of the breast is more common in females. Additionally, the average age for developing this subtype of cancer is higher in breast than in lung patients, ranging mainly from 60 to 70 years of age.7 "
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    ABSTRACT: In this case study and review, we present a case of a primary small-cell neuroendocrine carcinoma (SCNC) of the male breast. Primary SCNC of the breast is a rare tumor with less than 30 cases reported in the literature. Most cases are found in women. Another exceptional point is that human epidermal growth factor receptor-2 (Her-2) immunoreactivity was positive in our recent case, which differed to previous reports detailing SCNC in women. We have no evidence to demonstrate the differences between treatment and prognoses for males and females, because we do not have sufficient cases to undertake an evidence-based investigation. We provide this rare case history; review the literature on SCNC of the breast; and discuss detailed information regarding epidemiology, histogenesis, clinical and histologic diagnosis criteria, surgical and adjuvant treatment, and prognosis.
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    • "The prognosis for this rare tumor remains controversial. Recent reports, which only deal with small cell neuroendocrine carcinoma, indicate that the size, stage of disease at the time of diagnosis, expression of the ER and PR, and the Ki-67 index are important determinants of the prognosis (11-13). There is no relevant report about the prognosis of primary large cell neuroendocrine carcinoma seen in our case. "
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    ABSTRACT: Focal neuroendocrine differentiation can be found in diverse histological types of breast tumors. However, the term, neuroendocrine breast tumor, indicates the diffuse expression of neuroendocrine markers in more than 50% of the tumor cell population. The imaging features of neuroendocrine breast tumor have not been accurately described due to extreme rarity of this tumor type. We present a case of a pathologically confirmed, primary neuroendocrine breast tumor in a 42-year-old woman, with imaging findings difficult to be differentiated from that of invasive ductal carcinoma.
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    • "The NEBC case described herein was positive for both ER and PR. Regarding treatment, anthracycline-based chemotherapy is the first choice, and maintenance hormone therapy has been generally prescribed for the management of patients with ER/PR-positive NEBC (16). For our patient, we initially used letrozole as hormone therapy in a neoadjuvant setting (2.5 mg/day for four months) due to the tumor size (7 cm) and to avoid the undesirable treatment of the mesenteric mass with conventional chemotherapy. "
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    ABSTRACT: Neuroendocrine tumors (NETs) are frequently associated with second primary malignancies (SPMs). Earlier studies have demonstrated that NETs are highly associated with synchronous or metachronous gastrointestinal and genitourinary SPMs. We report, for the first time, a case of pure NE breast carcinoma (NEBC) exhibiting all of the World Health Organization (WHO)-categorized morphological and phenotypic NE features (i.e., round solid nests of spindle cells, plasmacytoid cells, large clear or mucinous signet-ring cells with a peripheral palisading tendency and immunohistochemical positivity for the NE markers synaptophysin and chromogranin in more than 50% of the tumor cell population) along with synchronous abdominal non-Hodgkin's lymphoma. In the present study, we review the diagnosis, clinicopathological features and histogenetic profiling of NEBC and discuss the literature relevant to the clinical and anatomopathological management of this case. This previously unreported case of synchronous solid NEBC and abdominal lymphoma, together with earlier studies showing that primary symptoms are caused by SPMs in a significant subgroup of NET patients, strongly supports the notion that NETs should be cautiously considered to be index tumors. Therefore, risk-adapted clinicopathological follow-up with systematic investigation is strongly recommended.
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