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Neuroendocrine Tumor Presented With Axillary Mass: A Case Report
María de Las Nieves Sicilia Pozo1, Fernando López-Bermejo García1, Niletys Ruiz Disotuar1
1From the Department of Nuclear Medicine, University General Hospital of Ciudad Real, Ciudad Real.
Clinical Nuclear Medicine
|February 13, 2024
Summary
Neuroendocrine tumors can present as axillary masses, challenging initial diagnoses. This case highlights the importance of considering neuroendocrine tumors in the differential diagnosis of axillary lymphadenopathy.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Axillary masses are common and typically associated with infections or lymphoproliferative disorders.
- Neuroendocrine tumors (NETs) are rare malignancies that can arise from various tissues and present with diverse clinical manifestations.
Observation:
- A 79-year-old male presented with a palpable left axillary mass and ultrasonography findings suggestive of conglomerate lymph nodes.
- Histopathology revealed a grade 3 neuroendocrine tumor, contrary to the initial suspicion of a lymphoproliferative disorder.
- The tumor demonstrated somatostatin receptor overexpression on 99m Tc-HYNIC-TOC scintigraphy and high uptake on 18 F-FDG PET/CT.
- Bilateral hypermetabolic adrenal nodes, indicative of metastases, were also identified.
Findings:
- The neuroendocrine tumor exhibited characteristic imaging findings on both somatostatin receptor scintigraphy and 18 F-FDG PET/CT.
- The patient received chemotherapy and immunotherapy, resulting in a partial metabolic response after four cycles of treatment.
- This case underscores the utility of advanced imaging modalities in the diagnosis and staging of neuroendocrine tumors.
Implications:
- Neuroendocrine tumors should be included in the differential diagnosis of axillary masses, especially when initial investigations are inconclusive.
- Integrated imaging approaches (scintigraphy and PET/CT) are crucial for accurate diagnosis, staging, and monitoring treatment response in neuroendocrine tumors.
- This case contributes to the understanding of rare presentations of neuroendocrine tumors and emphasizes the need for a broad differential diagnosis in clinical practice.
