Metastatic large cell neuroendocrine lung cancer to the foramen magnum: A case report

Abstract

Rationable: Large cell neuroendocrine carcinoma of the lung is rare, especially in the area of the foramen magnum. No previous studies have reported metastatic large cell neuroendocrine lung cancer to the foramen magnum. This paper will be the first time to report this special case.

Patient concerns: A case of a 37-year-old woman presented with headache that had developed 20 days previously. Imaging examination revealed a circular abnormal signal at the posterior margin of the foramen magnum.

Diagnoses: The patient we report was diagnosed with a metastatic intracranial tumor.

Interventions: The patient underwent occipital craniotomy. Pathological results showed metastatic neuroendocrine carcinoma of the brain. Whole body PET-CT examination showed that fusiform soft tissue shadows could be seen near the hilum of the lower lobe of the left lung.

Outcomes: The final bronchoscopy pathological results showed the large cell neuroendocrine carcinoma of the lung. The patient underwent further chemotherapy and radiotherapy in the oncology department.

Lessons: Diagnosis and treatment of large cell neuroendocrine carcinoma of the lung are difficult. The prognosis is poorer, and effective treatment is urgently needed.

Figure 1

Preoperative cranial magnetic resonance suggested a circular abnormal signal at the posterior margin of the foramen magnum, with clear boundaries and a size of about 2.5 cm × 1.9 cm × 2.6 cm. After enhanced scanning, the signal was significantly enhanced, and the dorsal medulla oblongata was compressed. Postoperative MRI on the second day after surgery suggested complete resection of the tumor.

Figure 2

The histological features of brain tumors were as follows: nest arrangement of heterosexual cells, large and dark nuclei, high cell density, and scattered mitosis. HE = A × 50; B × 200.

Figure 3

Whole body PET-CT showed that fusiform soft tissue shadows with a size of about 43 mm × 22 mm × 32 mm could be seen near the hilum of the lower lobe of the left lung. Glucose metabolism was increased and the edges were lobulated. Malignant lesions were mainly considered.