原发性乳腺神经内分泌癌1例报道及文献复习

Primary breast neuroendocrine carcinoma:a case report and literature review

目的 对1例原发性乳腺神经内分泌癌(NEBC)病例进行报道,为该病的诊断及治疗提供临床参考。方法 回顾性报道江苏省中医院2021年9月13日收治的1例54岁女性原发性NEBC的诊疗过程,并结合相关文献进行分析。结果 患者因单侧无痛性乳房肿块就诊,肿块穿刺病理考虑非特殊类型乳腺癌伴神经内分泌分化,行手术治疗,术后病理加做免疫组化确诊为原发性NEBC,术后行进一步综合治疗,门诊随访1年未见局部复发及远处转移。结论 原发性NEBC是一种罕见的特殊类型的乳腺癌,多见于绝经后女性,缺乏特异性临床表现,确诊需病理及免疫组化;目前普遍认为嗜铬粒蛋白A(CgA)和突触素(Syn)是诊断NEBC的可靠标志物。其治疗方案尚未形成统一标准,临床多参考相同病理分期一般类型乳腺癌。其预后文献报道不一,尚未达成共识。

Objective To report a case of primary neuroendocrine breast cancer(NEBC),and to provide clinical reference for the diagnosis and treatment of the disease.Methods The diagnosis and treatment process of a 54-year-old female patient with NEBC admitted to Jiangsu Province Hospital of Chinese Medicine on September 13,2021 was retrospectively reported,and analyzed in combination with relevant literature.Results The patient was admitted due to unilateral painless breast mass.The patient was considered to have a non-special type of breast cancer with neuroendocrine differentiation and underwent surgery.The diagnosis of NEBC was confirmed by pathology and immunohistochemistry after operation.Further comprehensive treatment was given and no local recurrence or distant metastasis was found in the 1-year follow-up.Conclusion NEBC is a rare and special type of breast carcinoma which lacks specific clinical manifestations.Pathology and immunohistochemistry are required for diagnosis.Chromogranin A(CgA) and sunaptophysin(Syn) are generally considered to be reliable markers for the diagnosis of NEBC.The treatment plan has not yet formed a unified standard.Treatment guidelines for general type of breast cancer of the same pathological stage are mostly referred to.There is still no consensus on its prognosis.