Zorlu bir meme kanseri türü; Nöroendokrin tümörlere farklılaşma

Öz

Amaç: Nöroendokrin tip meme karsinomlarına nadiren rastlanmaktadır. Bu tümörlerin çoğu hücreye göre farklılaşmış nöroendokrin göğüs karsinoması olarak görülmekle birlikte, bu nadiren de olsa, saf nöroendokrin göğüs karsinoması olarak adlandırılan daha seyrek bir türü vardır. Nöroendokrin tümörlerin ortak yerleri akciğer ve gastrointestinal sistemdir (mide ve pankreas). Tahminler değişse de, klinik olarak önemli nöroendokrin tümörlerin yıllık insidansı 500.000'de yaklaşık 6.5-5; üçte ikisi karsinoid tümörler, üçte biri diğer nöroendokrin tümörlerdir. Tahmini yaygınlık her 100.000 için 35'tir. Bu yazıda meme problemi ile başvuran ve nöroendokrin diferansiyasyon gösteren meme kanseri veya tamamen nöroendokrin tümör tanısı alan hastalar incelenmiştir.

Yöntemler: Retrospektif kohort çalışması, nöroendokrin meme kanseri hastalarını incelemek üzere tasarlanmıştır. Neoplazmda nöroendokrin bileşenlere sahip patolojik inceleme yapılmış kadın hastalar gözden geçirildi. Hastaların demografik özellikleri, preoperatif görüntüleme, tanı değerlendirmeleri, ameliyat ve patolojik inceleme kayıtları kaydedildi.

Bulgular: Çalışma döneminde 11 hastada nöroendokrin meme kanseri tespit edildi. Tüm hastalara, spesifik olmayan meme kanseri gibi standart terapi uygulanmıştır. Ameliyat öncesi dönemde 11 hastanın sadece ikisinde (%18) biyopsi ile nöroendokrin farklılaşma saptanmıştır. Bir hasta neoadjuvan tedavi aldı. Sekiz hastada (%72,8) modifiye radikal mastektomi uygulandı. Geri kalan üç hastada meme koruyucu cerrahi uygulandı.

Sonuç: Nöroendokrin meme kanseri nadir görülen bir hastalıktır ve preoperatif dönemde teşhis zor olabilir. Çoğu durumda, doğru teşhis, cerrahi sonrası numunenin uygun şekilde incelenmesinden sonra yapılır. Spesifik tedaviler için gelecek çalışmalar ilgi çekici olacaktır.

Anahtar Kelimeler

• Meme kanseri,Nöroendokrin tümör

A challenging breast cancer type; Differentiation to neuroendocrine tumors

Abstract

Aim: Neuroendocrine type breast carcinomas are rarely observed. Most of these tumors are seen as cell-differentiated neuroendocrine breast carcinoma but with all this infrequency, there is also a rarer type which is called as pure neuroendocrine breast carcinoma. The common locations for neuroendocrine tumors are lung and gastrointestinal system (stomach and pancreas). Although estimations vary, the annual incidence of clinically significant neuroendocrine tumors is approximately 6.5-5 per 500,000; two thirds are carcinoid tumors and one third are other neuroendocrine tumors. The estimated prevalence is 35 per 100,000. In this article, we analyze the patients admitted with breast problems and had the diagnosis of breast cancer with neuroendocrine differentiation or purely neuroendocrine tumor.

Methods: Retrospective cohort study is designed to review neuroendocrine breast cancer patients. Female patients with pathological examination which have neuroendocrine components in neoplasm were reviewed. Demographics, preoperative imaging, diagnostic evaluations, operation and pathological examination records of patients were recorded.

Results: Neuroendocrine breast cancer was observed in 11 patients in study period. All patients received standard therapy like non-specific breast cancer. Only two of 11 patients (18%) were diagnosed with neuroendocrine differentiation in preoperative period by biopsy. One patient received neoadjuvant treatment. Modified radical mastectomy was performed in eight patients (72.8%). Breast conserving surgery was performed in remaining three patients.

Conclusion: Neuroendocrine breast cancer is rare entity, and diagnose at preoperative period may be challenging. In most cases the correct diagnosis is made after proper examination of the postsurgical specimen. Future studies for specific treatments would be of interest.

Keywords

• Breast cancer,Neuroendocrine tumor

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