Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report

Metastatic neuroendocrine tumours (NETs) to the breast are very rare entities. A 26-year-old lady presented with anterior neck swelling with symptoms of superior vena cava syndrome for 6 months. Imaging study revealed a mediastinal mass which was preceded with core biopsy which was consistent with high-grade small cell NETs. Despite second-line adjuvant chemotherapy and radiotherapy, her disease became advanced which was confirmed via restaging scan. There were bilateral breast lesions discovered during the scan which was deemed to be metastatic NETs histologically. Despite prompt initiation of treatment, she succumbed 1 year after the radiotherapy due to disease progression. High suspicion of an index is needed for diagnosis when patients with known primary NETs present with suspicious breast lesions. Triple assessment is mandatory, however histopathology assessment and immunohistochemistry staining are the mainstay of diagnosis. •Metastatic breast neuroendocrine tumours are very rare entities especially when they arise from the mediastinum.•High suspicion of an index is needed for diagnosis when patients with known primary neuroendocrine tumours presented with suspicious breast lesions.•Any breast pathology requires a triple assessment including secondary breast neuroendocrine tumours.