Abstract
BackgroundNeuroendocrine tumors are a group of rare neoplasms, and the pancreatic neuroendocrine tumors (PNETs) represent only 1–2% of all pancreatic malignant tumors. The most common sites of these tumors include the gastrointestinal tract, lung, adrenal gland, and thyroid gland. Moreover, the most common sites of PNET metastases are the lymph nodes, liver, spleen, and bone.Case summaryA 40-year-old woman with pT3N1 PNET underwent surgical excision of the lesion (12 cm, at the level of the pancreatic body and tail). Postsurgical treatment included chemotherapy and radiation, both of which the patient showed a good tolerance for. After a 12-month disease-free interval, however, the patient reported the development of a lesion in her left breast and a small lesion in the left posterior region of her neck. The lesions were surgically excised, and the histological findings characterized both as pancreatic neuroendocrine metastatic poorly differentiated neoplasms (G3). A re-staging CT scan showed multiple metastases in the left axillary, clavicular, and latero-cervical lymph nodes, as well as diffuse osteolytic-osteoblastic bone metastases, almost mimicking the behavior of a primitive breast tumor.ConclusionThis case of breast and subcutaneous metastases from PNET should prompt awareness of potential metastatic lesions in unusual locations.
Highlights
Neuroendocrine tumors represent a group of rare neoplasms, with an overall incidence of approximately 5.25/ 100000 [1]
We report the case of a woman with breast and subcutaneous pancreatic neuroendocrine tumors (PNETs)’ metastases
PNETs derived from different neuroendocrine cells are a clinically rare and heterogeneous disease of the pancreas, accounting for 7% of all neuroendocrine tumors
Summary
PNETs are a heterogeneous group of tumors that a multidisciplinary team should be involved in determining the optimal treatment approach for according to the various factors connected to tumor stage and behavior. Our PNET case is distinctive for its metastases to breasts and subcutaneous tissue As such, it highlights the importance of clinicians’ awareness of the possibility of a metastatic lesion when evaluating breast lesions in patients with primary tumor(s) in other organ(s), PNETs. Cutaneous and subcutaneous metastasis from neuroendocrine tumors is very rare, with less than 50 reported cases in the literature. Immunohistochemical markers are very important to improve the prognostic classification of PNETs. PNETs are a heterogeneous group of tumors and their treatment approach should consider factors connected to the tumor stage and behavior, as assessed and discussed by a multidisciplinary team
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