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Journal of Case Reports
Chest Wall PNET Masquerading as Breast Lump: A Case Report with Diagnostic Challenge
Vachaspati Kumar Mishra1, Ajeet Kumar Gandhi1, Madhup Rastogi1, Satyajeet Rath1, Akash Agarwal2, Ayushi Patni1, Avinash Poojari1, Nuzhat Husain3
Departments of 1Radiation Oncology, 2Surgical Oncology and 3Pathology; Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Corresponding Author:
Dr Satyajeet Rath
Email: satyajeetrath@gmail.com
Received: 08-DEC-2019 Accepted: 29-JAN-2020 Published Online: 05-FEB-2020
DOI: http://dx.doi.org/10.17659/01.2020.0007
Background: Chest wall primitive neuroectodermal tumor (PNET) is a rare tumor necessitating a prompt diagnosis. Unfortunately, the diagnosis of this tumor can be extremely challenging and misdiagnosis is at times unavoidable. CaseReport:  Here we present one such rare case of chest wall PNET. Patient initially had complaints of pain and lump in the right breast. Contrast enhanced computed tomography (CECT) of thorax showed large mass with both intra-thoracic and extra-thoracic extension. Trucut biopsy from lump was suggestive of PNET on histopathology and immunohistochemistry. Later patient was treated with induction chemotherapy with alternating VAC/IE followed by right chest wall resection. Post-operative histopathology was suggestive of complete pathological response. 18FDG PET-CT done subsequently was suggestive of complete metabolic response. Conclusion: Chest wall PNETs may mimic as breast lump, posing diagnostic dilemma. Multimodality treatment may yield excellent outcome as in our case.
Keywords : Biopsy, Diagnostic Errors, Thoracic Wall, Neuroectodermal Tumors, Pain.
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