A Case of Primary Mixed Small Cell Carcinoma of the Breast with Lymphnode Metastases with Different Histological Type

Abstract

A 74-year-old woman with dementia presented to our hospital with a 5 × 7 cm mass with a skin depression in the C area of the right breast. An enlarged lymph node was palpated in the right axilla. Breast ultrasound showed a lobulated hypoechoic mass in the C area of the right breast with relatively clear borders, heterogeneous internal echoes, and anterior and posterior borderline tears. A needle biopsy showed mixed images of invasive ductal carcinoma and small cell carcinoma. Mastectomy and axillary lymph node dissection were performed and postoperative histopathological examination revealed a diagnosis of mixed carcinoma with invasive ductal carcinoma and small cell carcinoma. Two lymph node metastases were found, which were invasive ductal carcinoma and small cell carcinoma, respectively. In selecting postoperative chemotherapy, we should take the two histologic types into account, but in this case, paclitaxel was administered due to limitations caused by dementia. As of 23 months since surgery, no signs of recurrence have been observed. In mixed small cell carcinoma, each histological type is considered to progress separately, and it is necessary to consider the histological type when selecting anticancer agents.