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21 May 2026 : Case report  Saudi Arabia

[In Press] Primary Small Cell Neuroendocrine Carcinoma of the Breast in a 75-Year-Old Woman With Aggressive Recurrence Despite Multimodal Therapy: A Case Report and Literature Review

Challenging differential diagnosis, Unusual setting of medical care, Rare coexistence of disease or pathology

Shefa Abdullah Alamoudi ORCID logo1ABCDEFG, Hadeel Elwaheidi1ABCDEFG, Hanan Albishi2ABCD, Sarah Aldosari ORCID logo3ABCDEFG, Asma M. Tulbah4CD, Wafa Alkhayal5ABCDEFG

DOI: 10.12659/AJCR.952443

Am J Case Rep In Press; DOI: 10.12659/AJCR.952443  

Available online: 2026-05-21, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Neuroendocrine breast tumors represent an uncommon subtype of breast cancer, accounting for less than 1% of all breast malignancies and fewer than 0.1% of all neuroendocrine tumors. Their histological and immunophenotypic features closely resemble neuroendocrine neoplasms of other organs, and diagnosis requires careful exclusion of extramammary primaries.
CASE REPORT
We present the case of a 75-year-old woman diagnosed with primary small cell neuroendocrine breast carcinoma following an incidental detection of a right breast mass. She underwent a simple mastectomy with sentinel lymph node biopsy, followed by adjuvant carboplatin-etoposide chemotherapy. One year later, she developed a solitary hepatic metastasis, which was successfully treated with metastasectomy and repeat adjuvant chemotherapy. Despite initial responses, subsequent surveillance imaging demonstrated progressive hepatic metastatic disease. This case underscores the aggressive clinical behavior and diagnostic challenges associated with high-grade neuroendocrine breast tumors. The 2019 WHO classification highlights the importance of distinguishing neuroendocrine carcinoma subtypes due to differing prognostic and therapeutic implications. Although multiple treatment modalities exist, outcomes remain poor in high-grade or advanced disease.
CONCLUSIONS
Neuroendocrine breast tumors remain insufficiently understood because of their rarity. This report highlights the importance of thorough histopathological evaluation, meticulous exclusion of extramammary primaries, and close longitudinal follow-up. Additional research is needed to establish standardized diagnostic and therapeutic guidelines.

Keywords: Breast Diseases; Breast Neoplasms; Case Reports; Literature Review; Neuroendocrine Tumors; Oncology; Rare Diseases

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923