Abstract
We report a case of well-differentiated mucinous neuroendocrine carcinoma in an aged woman who presented with a right breast lump. The mammogram revealed a dense, lobulated mass with a circumscribed margin. The core needle biopsy was initially misdiagnosed as an invasive ductal carcinoma, and modified radical mastectomy was performed later. A detailed histologic examination of the whole specimen revealed a solid and expansile growth pattern of epithelial cells with a trabecular arrangement. Almost all the tumor cells contained intracellular mucin, and some tumor cell clusters floated in a large amount of extracellular mucus. The differential diagnoses of primary neuroendocrine carcinoma of breast include mucinous carcinoma, invasive ductal carcinoma, invasive lobular carcinoma, and metastatic neuroendocrine carcinoma. The immunohistochemical studies demonstrated that the majority of tumor cells were immunoreactive for neuroendocrine markers that included chromogranin A, synaptophysin and neuronspecific enolase. Recognition of the neuroendocrine (NE) carcinoma showing a solid trabecular growth pattern with florid intracellular and extracellular mucin production is occasionally one of the most challenging diagnoses in small biopsy. There is no standard therapy for patients with NE carcinomas, however, surgery is regarded as the treatment of choice. The surgical protocol includes lumpectomy, axillary lymph node dissection and adjuvant radiation therapy or modified radical mastectomy based primarily on the tumor grade, size and stage. The chemotherapeutic agents or hormone therapy may be given accordingly.
Published Version
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