Small cell mammary neuroendocrine carcinoma - case presentation

Abstract

Neuroendocrine carcinomas are very rare and develop from the neuroendocrine cells which are present in the whole body. The carcinomas usually appear in the bronchopulmonary or the gastrointestinal tract, but these can also occur in the mammary glands. There have been reported only about 50 cases of this type of cance in the medical literature. The diagnosis is set on the presence of neuroendocrine markers present in the tumor cells (ex. Neuron Specific Enolase - NSE). Female patient aged 40, presents to the hospital for further investigation after the appearance of a mass at the level of the left breast. The clinical exam showed the presence of a painless tumoral mass with a diameter of 2cm. The anatomopathological and the imunohistochemical exams revealed the presence of a small cell neuroendocrine carcinoma. The CT exam (thorax, abdomen, pelvis with constrast substance) exposed nodular hyperactive nodules at the level of the left mammary gland, left axillar adenopathy without other pathological changes. The final diagnosis was primary mammary neuroendocrine carcinoma with resection recommendation. The patient’s tumor and the lymph nodes from the first axillary station were excised and metastases were revealed in 3 of the 6 examined lymph nodes. The patient had cytostatic treatment to avoid recidive. The patient continues the cytostatic and radiotherapy but the prognosis is reserved due to metastases present in the axillary lymph nodes. The precocious discovery and the quick onset of treatment are vital for the increase in survival chances of patients.