[Neuroendocrine differentiation in breast cancer]

Breast neuroendocrine tumor arising in the axilla of a man: a case report

BACKGROUND

Accessory breast carcinomas of the axilla of males are rare, and primary breast neuroendocrine tumors (BNETs) are rare as well. We present a case of a BNET arising in the axilla of a man.

CASE PRESENTATION

A 64-year-old Japanese man presented with a hard 15-mm mass in the axilla and axillary lymph node swelling. Histopathological examination of the incisional biopsy specimen revealed a neuroendocrine carcinoma. Therefore, wide radical excision of the axillary tumor and axillary lymph node dissection were performed. Hematoxylin and eosin staining showed that the solid tumor was mainly located in the subcutaneous adipose tissues and appeared to invade the skin. The tumor phenotypes were positive for CAM 5.2, synaptophysin, estrogen receptor, progesterone receptor, and GATA-binding protein 3; they were negative for human epidermal growth receptor 2. The neuroendocrine component comprised more than 90% of the tumor, and the Ki-67 index was 21%. These results indicated that the tumor was a BNET. This patient underwent adjuvant chemotherapy, endocrine therapy, and radiotherapy.

CONCLUSIONS

BNET cases in males are rare. The clinical and histological criteria as well as treatment for these rare cases are discussed.

Fluoride Can Damage the Spleen of Mice by Perturbing Th1/Th2 Cell Balance

To investigate the mechanism of fluoride-induced splenic toxicity, 0, 25, 50, and 100 mg/L sodium fluoride (NaF) were administered in male mice via drinking water for 90 days. After NaF treatment, the histological structure of the spleen, the proportion of helper T 1 cell (Th1) and helper T 2 cell (Th2), and the relative expression levels of cytokines and T-bet and GATA3 were analyzed. The results showed that 50 and 100 mg/L NaF consumption can change the normal structure of mouse spleen and the proportion of Th1/Th2 cells. It also decreased the mRNA expression levels of IL-2, INF-γ, and TGF-β, but increased the levels of IL-4, IL-6, and IL-10. Importantly, fluoride increased the protein expression of GATA3 but decreased the expression of T-bet. Our findings indicate that superfluous fluoride intake damages the balance of Th1/Th2 cells by changing the levels of T-bet and GATA3 in the spleen, and further changes the expression of Th1/Th2 cell-related cytokines in the spleen microenvironment, eventually leading to spleen injury.

Primary Neuroendocrine Neoplasms of the Breast: Still Open Issues

Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1% of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain. In the present short review of the medical literature on this topic, we have evaluated in details their epidemiology, risk factors, pathogenesis, pathology, clinical presentation, radiographic aspects, prognosis, and therapy. We have thus been able to identify a number of open issues regarding primary neuroendocrine neoplasms of the breast that need to be clarified. Our ultimate aim was actually to try to understand whether neuroendocrine neoplasms of the breast can be considered a definite clinical entity and if neuroendocrine differentiation of breast tumors has a really clinical relevance.

Correct Identification of Cell of Origin May Explain Many Aspects of Cancer: The Role of Neuroendocrine Cells as Exemplified from the Stomach

Cancers are believed to originate from stem cells. Previously, the hypothesis was that tumors developed due to dedifferentiation of mature cells. We studied the regulation of gastric acid secretion and showed that gastrin through the gastrin receptor stimulates enterochromaffin-like (ECL) cell histamine release and proliferation. In animal and human studies, we and others showed that long-term hypergastrinemia results in ECL cell-derived tumor through a sequence of hyperplasia, dysplasia, neuroendocrine tumors (NETs), and possibly neuroendocrine carcinomas (NECs) and adenocarcinomas of diffuse type. Perhaps, other cancers may also have their origin in differentiated cells. Knowledge of the growth regulation of the cell of origin is important in cancer prophylaxis and treatment. Physiology plays a central role in carcinogenesis through hormones and other growth factors. Every cell division implies a small risk of mutation; thus mitogens are also mutagens. Moreover, metastasis of slow proliferating cells may also explain so-called tumor dormancy and late recurrence.