Zorlu bir meme kanseri türü; Nöroendokrin tümörlere farklılaşma

Yıl 2017, , 32 - 35, 23.08.2017

Ömer Serdar Yıldız , Fatih Başak

https://doi.org/10.28982/josam.342305

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

Öz

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.

Anahtar Kelimeler

Breast cancer, Neuroendocrine tumor

Kaynakça

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