Breast metastasis from the pancreatic neuroendocrine tumor origin detected by 99mTc-Octreotate scan

Document Type : Case Report


1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Hematology-Oncology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


A 50 years old woman with history of pancreatic neuroendocrine tumor diagnosed 2 years ago, which has not been surgically removed,was referred to our department for a 99mTc-Octreotate in order to evaluate the somatostatin receptor status. She was treated with regular sandostatin injections and chemotherapy. Her CT scan which was previously performed confirmed lung, adrenal and hepatic metastases. In her original pancreatic mass biopsy, well-differentiated neuroendocrine tumor of the pancreas with 3% rate of KI-67 positivity was reported. Whole body 99mTc-Octreotate scan was obtained 4 hours post-intravenous injection of 20 mCi of the radiotracer showed multiple areas of increased tracer uptake in the pancreas, left adrenal, both breasts and left axillary region. Considering the fact that metastasis of the pancreatic NET to the breast is extremely rare, we recommended mammographic correlation and tissue biopsy. Her CT scan images and mammography confirmed breast masses and the biopsy revealed metastatic NET from the pancreatic origin.


Main Subjects

  1. Richter-Ehrenstein C, Arndt J, Buckendahl AC, Eucker J, Weichert W, Kasajima A, Schneider A, Noske A. Solid neuroendocrine carcinomas of the breast: metastases or primary tumors? Breast Cancer Res Treat. 2010 Nov;124(2):413-7.
  2. Van Laarhoven HA, Gratama S, Wereldsma JC. Neuroendocrine carcinoid tumours of the breast: a variant of carcinoma with neuroendocrine differentiation. J Surg Oncol. 1991 Feb;46(2):125-32.
  3. Ni K, Bibbo M. Fine needle aspiration of mammary carcinoma with features of a carcinoid tumor. A case report with immunohistochemical and ultrastructural studies. Acta Cytol. 1994 Jan-Feb;38(1):73-8.
  4. O'Donnell ME, McCavert M, Carson J, Mullan FJ, Whiteside MW, Garstin WI. Non-epithelial malignancies and metastatic tumours of the breast. Ulster Med J. 2009 May;78(2):105-12.
  5. Glazebrook KN, Jones KN, Dilaveri CA, Perry K, Reynolds C. Imaging features of carcinoid tumors metastatic to the breast. Cancer Imaging. 2011 Jun 29;11:109-15.
  6. Kojima M, Ikeda K, Saito N, Sakuyama N, Koushi K, Kawano S, Watanabe T, Sugihara K, Ito M, Ochiai A. Neuroendocrine tumors of the large intestine: clinicopathological features and predictive factors of lymph node metastasis. Front Oncol. 2016 Jul 18;6:173.
  7. Mohanty SK, Kim SA, DeLair DF, Bose S, Laury AR, Chopra S, Mertens RB, Dhall D. Comparison of metastatic neuroendocrine neoplasms to the breast and primary invasive mammary carcinomas with neuroendocrine differentiation. Mod Pathol. 2016 Aug;29(8):788-98.
  8. Crona J, Granberg D, Norlén O, Wärnberg F, Stålberg P, Hellman P, Björklund P. Metastases from neuroendocrine tumors to the breast are more common than previously thought. A diagnostic pitfall? A diagnostic pitfall? World J Surg. 2013 Jul;37(7):1701-6.