Background: To investigate the clinicopathological characteristics of infiltrating ductal carcinoma of the breast with neuroendocrine differentiation and metastasis to the stomach, colon and lung at the same time. Methods: To The histopathological characteristics and immunophenotype of a case of breast invasive ductal carcinoma with neuroendocrine characteristics and concurrent gastric, colon and lung metastases were observed. Results: The histological structure and cell morphology of the primary lesions and metastatic lesions of breast invasive ductal carcinoma with neuroendocrine differentiation were basically the same, and they were all non-lumen invasive ductal carcinoma of the breast. The antibody markers of this case of breast invasive ductal carcinoma were as follows: the primary and metastatic foci were all positive for E-cad, p120 and ER, while PR, HER2, GATA3, Mammaglobin and GCDFP-15 were all negative. The antibody markers of non-breast tissues were as follows: TTF1, CgA and Sym were positively expressed in primary and metastatic foci. This tumour was extremely rare and had characteristic histomorphological changes. Conclusion: The diagnosis of invasive breast carcinoma with neuroendocrine differentiation should be based on histology and cell morphology, CgA and SyN-positive expression, mitosis and cell proliferation index ki-67 positive cell comprehensive analysis, in order to improve understanding and early diagnosis and avoid missed diagnosis and misdiagnosed cases.