title: Breast metastasis and lung large-cell neuroendocrine carcinoma: first clinical observation.
abstract: OBJECTIVE
  The lung large-cell neuroendocrine carcinoma (LCNEC) is a very rare aggressive neuroendocrine tumor with a high propensity to metastasize and very poor prognosis. We report an atypical presentation of lung LCNEC was diagnosed from a metastatic nodule on the breast.
  
  
  METHODS
  Our patient is a 59-years-old woman that presented in March 2014 nonproductive cough. A CT scan showed multiple brain, lung, adrenal gland and liver secondary lesions; moreover, it revealed a breast right nodule near the chest measuring 1.8 cm. The breast nodule and lung lesions were biopsied and their histology and molecular diagnosis were LCNEC of the lung. To our knowledge, this is the first documented case of breast metastasis from LCNEC of the lung.
  
  
  RESULTS
  Furthermore, breast metastasis from extramammary malignancy is uncommon and its diagnosis is difficult but important for proper management and prediction of prognosis. Therefore, a careful clinical history with a thorough clinical examination is needed to make the correct diagnosis. Moreover, metastasis to the breast should be considered in any patient with a known primary malignant tumor history who presents with a breast lump. Anyhow, pathological examination should be performed to differentiate the primary breast cancer from metastatic tumor.
  
  
  CONCLUSIONS
  Therefore, an accurate diagnosis of breast metastases may not only avoid unnecessary breast resection, more importantly it is crucial to determine an appropriate and systemic treatment.
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Anselmo
authors.initials: A
authors.lastname: Papa
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Rossi
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Verrico
authors.affiliation: Histopathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Di Cristofano
authors.affiliation: Histopathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Moretti
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Strudel
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Zoratto
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Minozzi
authors.affiliation: Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Polo Pontino, Latina, Italy.
authors.forename: Silverio
authors.initials: S
authors.lastname: Tomao
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D018278:Carcinoma, Neuroendocrine / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods
chemical_list: D000970:Antineoplastic Agents
keywords: breast metastasis - differential diagnosis - large-cell neuroendocrine cancer - lung cancer