原发性乳腺癌伴肝转移性神经内分泌癌：诊疗挑战与治疗思考(附1例报告)

Primary Breast Cancer with Liver Metastatic Neuroendocrine Carcinoma: Diagnostic and Therapeutic Challenges and Treatment Considerations (with a Case Report)

摘要: 目的：乳腺癌肝转移常见，但神经内分泌分化极罕见。本文通过对1例原发性乳腺癌伴肝转移性神经内分泌癌病例进行报道，以探讨该病的临床特征及诊疗策略，以期提高对该罕见疾病的认识。方法：对青岛大学附属医院2024年8月30日收治的1例56岁女性患者的临床病例资料进行回顾性分析，并结合相关文献进行分析。结果：患者因左侧无痛性乳房肿块行改良根治术，病理证实为神经内分泌癌，经多线治疗无效，随访截止于2024年10月29日。后续患者失访。结论：乳腺癌异质性较强，而神经内分泌分化在乳腺癌中较罕见，临床表现缺乏特异性，对于诊断有一定的挑战性，病理及分子检测可以作为评估肿瘤的重要辅助成分。全身治疗是乳腺癌伴转移性神经内分泌癌的关键治疗方法，然治疗方案尚未形成统一标准，未来需要进一步探讨思考标准治疗方案。

Abstract: Objective: Hepatic metastasis of breast cancer is common, but neuroendocrine differentiation is extremely rare. This article reports a case of primary breast cancer with liver metastatic neuroendocrine carcinoma to explore the clinical features and treatment strategies of this disease, with the aim of enhancing the understanding of this rare condition. Methods: A retrospective analysis was conducted on the clinical data of a 56-year-old female patient admitted to the Affiliated Hospital of Qingdao University on August 30, 2024, and the relevant literature was reviewed. Results: The patient underwent modified radical mastectomy due to a painless mass in the left breast. Pathology confirmed neuroendocrine carcinoma. Despite multiple lines of treatment, the patient did not respond. Follow-up was discontinued on October 29, 2024, and the patient was lost to follow-up. Conclusion: Breast cancer is highly heterogeneous, and neuroendocrine differentiation is rare in breast cancer. The clinical manifestations lack specificity, posing a challenge for diagnosis. Pathological and molecular testing can serve as important auxiliary components for tumor assessment. Systemic treatment is the key approach for breast cancer with metastatic neuroendocrine carcinoma, but a unified treatment standard has not yet been established. Further exploration and consideration of standard treatment regimens are needed in the future.