Surgery Today

, 38:734

Primary small-cell neuroendocrine carcinoma of the breast: Report of a case

  • Satoki Kinoshita
  • Akio Hirano
  • Kazumasa Komine
  • Susumu Kobayashi
  • Shigeya Kyoda
  • Hiroshi Takeyama
  • Ken Uchida
  • Toshiaki Morikawa
  • Jison Nagase
  • Goi Sakamoto
Case Reports

Abstract

Primary small-cell neuroendocrine carcinoma of the breast is a rare and aggressive neoplasm without an established treatment protocol because so few cases have been described. We report a case of primary smallcell neuroendocrine carcinoma in a 31-year-old woman. The patient came to our hospital 10 days after consulting another clinic, where a diagnosis of locally advanced breast cancer suitable for neoadjuvant chemotherapy had been made. Core needle biopsy under ultrasonographic guidance revealed invasive carcinoma. The doubling time of the tumor progression was calculated as 12 days based on ultrasonographic measurement. After three cycles of chemotherapeutic regimens consisting of adriamycin plus docetaxel, the disease was judged to be progressive and the patient underwent surgery. Definitive histopathological examination revealed primary small-cell neuroendocrine carcinoma. Local and mediastinal recurrence with multiple liver metastases developed only 5 weeks after surgery. Cisplatin plus irinotecan combination chemotherapy was started; however, the patient died of aggressive recurrent tumor progression 6 months after surgery, in spite of the transient tumor regression achieved by chemotherapy. This case reinforces the importance of an early correct diagnosis and the standardization of a treatment regimen for this very rare tumor.

Key words

Small cell Neuroendocrine Breast cancer Irinotecan Doubling time 

References

  1. 1.
    Frazier SR, Kaplan PA, Loy TS. The pathology of extrapulmonary small cell carcinoma. Semin Oncol 2007;34:30–38.PubMedCrossRefGoogle Scholar
  2. 2.
    Rosen PP. Rosen’s breast pathology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 503–508.Google Scholar
  3. 3.
    Mizra IA, Hahab N. Small cell carcinoma of the breast. Semin Oncol 2007;34:64–66.CrossRefGoogle Scholar
  4. 4.
    Wade PM Jr, Mills SE, Read M, Cloud W, Lambert MJ, Smith RE. Small cell neuroendocrine (oat cell) carcinoma of the breast. Cancer 1983;52:121–125.PubMedCrossRefGoogle Scholar
  5. 5.
    Jundt G, Schulz A, Heitz PU, Osborn M. Small cell neuroendocrine (oat cell) carcinoma of the male breast. Virchows Arch A Pathol Anat Histopathol 1984;404:213–221.PubMedCrossRefGoogle Scholar
  6. 6.
    Papotti M, Gherardi G, Eusebi V, Pagani A, Bussolati G. Primary oat cell (neuroendocrine) carcinoma of the breast. Virchows Arch A Pathol Anat Histopathol 1992;420:103–108.PubMedCrossRefGoogle Scholar
  7. 7.
    Francois A, Chatikhine VA, Chevallier B, Ren GS, Berry M, Chevrier A, et al. Neuroendocrine primary small cell carcinoma of the breast. Am J Clin Oncol 1995;18:133–138.PubMedCrossRefGoogle Scholar
  8. 8.
    Chua RS, Torno RB, Vuletin JC. Fine needle aspiration cytology of small cell neuroendocrine carcinoma of the breast. Acta Cytol 1997;41:1341–1344.PubMedGoogle Scholar
  9. 9.
    Fukunaga M, Ushigome S. Small cell (oat cell) carcinoma of the breast. Pathol Int 1998;48:744–748.PubMedCrossRefGoogle Scholar
  10. 10.
    Yamasaki T, Shimazaki H, Aida S, Tamai S, Tamaki K, Hiraide H, et al. Primary small cell (oat cell) carcinoma of the breast: Report of a case and review of the literature. Pathol Int 2000;50:914–918.PubMedCrossRefGoogle Scholar
  11. 11.
    Shin SJ, DeLellis RA, Ying L, Rosen PP. Small cell carcinoma of the breast. A clinicopathologic and immunohistochemical study of nine patients. Am J Surg Pathol 2000;24:1231–1238.PubMedCrossRefGoogle Scholar
  12. 12.
    Samli B, Celik S, Evrensel T, Orhan B, Tasdelen I. Primary neuroendocrine small cell carcinoma of the breast. Arch Pathol Lab Med 2000;124:296–298.PubMedGoogle Scholar
  13. 13.
    Salmo EN, Connolly CE. Primary small cell carcinoma of the breast: report of a case and review of the literature. Histopathology 2001;38:277–278.PubMedCrossRefGoogle Scholar
  14. 14.
    Hoang MP, Maitra A, Gazdar AF, Albores-Saavedra J. Primary mammary small-cell carcinoma: a molecular analysis of 2 cases. Hum Pathol 2001;32:753–757.PubMedCrossRefGoogle Scholar
  15. 15.
    Bergman S, Hoda SA, Geisinger KR, Creager AJ, Trupiano JK. E-cadherin-negative primary small cell carcinoma of the breast. Am J Clin Pathol 2004;121:117–121.PubMedCrossRefGoogle Scholar
  16. 16.
    Sridhar P, Matery P, Aluwihare N. Primary carcinoma of the breast with small-cell differentiation. Breast 2004;13:149–151.PubMedCrossRefGoogle Scholar
  17. 17.
    Bigotti G, Butti A, del Vecchio M, Tartaglione R, Massi G. Primary small cell neuroendocrine carcinoma of the breast. J Exp Clin Cancer Res 2004;23:691–696.PubMedGoogle Scholar
  18. 18.
    Jochems L, Tjalma WAA. Primary small cell neuroendocrine tumor of the breast. Eur J Obstet Gynecol Reprod Biol 2004;115:231–233.PubMedCrossRefGoogle Scholar
  19. 19.
    Yamamoto J, Ohshima K, Nabeshima K, Ikeda S, Iwasaki H, Kikuchi M. Comparative study of primary mammary small cell carcinoma, carcinoma with endocrine features and invasive ductal carcinoma. Oncol Rep 2004;11:825–831.PubMedGoogle Scholar
  20. 20.
    Adegbola T, Connolly CE, Mortiner G. Small cell neuroendocrine carcinoma of the breast: a report of three cases and review of the literature. J Clin Pathol 2005;58:775–778.PubMedCrossRefGoogle Scholar
  21. 21.
    Stein ME, Gershuny A, Abdach L, Quigeley MM. Primary small cell carcinoma of the breast. Clin Oncol 2005;17:201–202.CrossRefGoogle Scholar
  22. 22.
    Salman WD, Harrison JAF, Howat AL. Small-cell neuroendocrine carcinoma of the breast. J Clin Pathol 2006;59:888.PubMedCrossRefGoogle Scholar
  23. 23.
    Noda K, Nishiwaki Y, Kawahara M, Negoro S, Sugiura T, Yokogawa A, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small cell lung cancer. N Engl J Med 2002;346:86–91.CrossRefGoogle Scholar
  24. 24.
    Tavassoli FA, Devilee P. World Health Organization classification of tumors. Pathology and genetics of tumors of the breast and female genital organs. Lyon: International Agency for Research on Cancer (IARC) Press; 2003. p. 32–34.Google Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • Satoki Kinoshita
    • 1
  • Akio Hirano
    • 1
  • Kazumasa Komine
    • 2
  • Susumu Kobayashi
    • 1
  • Shigeya Kyoda
    • 3
  • Hiroshi Takeyama
    • 3
  • Ken Uchida
    • 3
  • Toshiaki Morikawa
    • 3
  • Jison Nagase
    • 4
  • Goi Sakamoto
    • 5
  1. 1.Department of Breast and Endocrine SurgeryJikei University Kashiwa HospitalKashiwa, ChibaJapan
  2. 2.Department of Clinical PathologyJikei University Kashiwa HospitalKashiwa, ChibaJapan
  3. 3.Department of Breast and Endocrine SurgeryJikei University School of MedicineTokyoJapan
  4. 4.Nagase Breast ClinicKashiwa, ChibaJapan
  5. 5.Sakamoto Memorial Clinic Academy of Breast PathologyTokyoJapan

Personalised recommendations