Chest Wall PNET Masquerading as Breast Lump: A Case Report with Diagnostic Challenge

Abstract

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. Case Report: 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. 18 FDG 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.