临床研究(Clinical Research)

乳腺神经内分泌癌3例诊治分析

Published at: 2017年第26卷第11期

王映 1 , 张超杰 1 , 黄淑麟 1 , 王毅夫 1 , 易红梅 2
1 湖南省人民医院/湖南师范大学附属第一医院乳腺甲状腺外科,湖南 长沙 410005
2 湖南省人民医院/湖南师范大学附属第一医院病理科,湖南 长沙 410005
通讯作者 超杰 张 Email: zhangchaojie74@126.com
DOI: 10.3978/j.issn.1005-6947.2017.11.013
基金:

摘要

目的:探讨乳腺神经内分泌癌的临床特点及诊治要点。方法:回顾性分析湖南省人民医院从2013年—2017年收治的3例乳腺神经内分泌癌的临床病理资料。结果:患者均为女性;年龄31~39岁;肿块大小0.5~4.0 cm;2例以乳房肿块就诊,1例以乳头溢液就诊;3例超声表现均为低回声结节;1例行改良根治术,1例行保留乳头乳晕改良根治+一期假体乳房再造术,1例行单纯乳房切除术。组织病理学形态包括实质性癌2例,小细胞性癌1例。免疫组化示 3例嗜铬粒蛋白A(CgA)及突触素(Syn)阳性,2例神经元特异性烯醇化酶(NSE)阳性。随访时间6~32个月,1例术后6个月因肝转移而死亡,另2例均无瘤生存。结论:乳腺神经内分泌癌是一种罕见的特殊类型乳腺癌,临床表现及影像学特征通常无特异性,诊断金标准是病理学及免疫组化检测,其治疗是以手术治疗为主的综合治疗,小细胞乳腺神经内分泌癌的预后差。


Analysis of diagnosis and treatment of three neuroendocrine breast cancer patients

Abstract

Objective: To investigate the clinical features of neuroendocrine tumor of the breast and its diagnosis and treatment. Methods: The clinicopathologic data of three patients with neuroendocrine tumor of the breast treated in Hunan Provincial People’s Hospital from 2013 to 2017 were retrospectively analyzed. Results: All three patients were female, with age of 31 to 39 years and tumor size of 0.5 to 4.0 cm. Two cases sought medical help for breast mass, and one case for nipple discharge. All cases presented with hypoechoic mass lesion in ultrasound scan. One case underwent modified radical mastectomy, one case underwent nipple-sparing modified radical mastectomy plus primary breast prosthesis reconstruction, and one case underwent simple mastectomy. The pathologic types included solid carcinoma in two cases and small cell carcinoma in one case. Immunohistochemical staining showed chromogranin A (CgA) and synaptophysin (Syn) positive in all the three cases and neuron-specific enolase (NSE) positive in two cases. Patients were followed up for 6 to 32 months, one case died of liver metastases at 6 months after excision, and 2 cases survived with tumor free status. Conclusion: Neuroendocrine tumor of the breast is a rare and special type of breast cancer. Its clinical features and imaging characteristics are usually nonspecific. Pathological and immunohistochemical examinations are considered as gold standard for its diagnosis. The comprehensive treatment with surgical treatment is the main method. Small cell neuroendocrine breast cancer has a poor prognosis.


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引用

引用本文: 映 王, 超杰 张, 淑麟 黄, 毅夫 王, 红梅 易. 乳腺神经内分泌癌3例诊治分析[J]. 中国普通外科杂志, 2017, 26(11): 1453-1459.
Cite this article as: WANG Ying, ZHANG Chaojie, HUANG Shulin, WANG Yifu, YI Hongmei . Analysis of diagnosis and treatment of three neuroendocrine breast cancer patients[J]. Chin J Gen Surg, 2017, 26(11): 1453-1459.