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Case Reports
. 2022 Jul;11(7):2438-2442.
doi: 10.21037/tcr-21-2793.

Progressive neuroendocrine tumor of lung with combined categories in metastatic site: a case report

Ling Ai  1 , Jingyuan Li  2 , Ting Ye  2 , Wenjun Wang  1 , Yuying Li  1
Affiliations
Case Reports

Progressive neuroendocrine tumor of lung with combined categories in metastatic site: a case report

Ling Ai et al. Transl Cancer Res. 2022 Jul.

Abstract

Background: Both large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) are high-grade neuroendocrine tumors of lung in classification. Combined LCNEC and combined SCLC may comprise up to 25% of the resected cases. However, co-existence of LCNEC and SCLC in lung accompanied with combined LCNEC in extrapulmonary metastatic sites is infrequent.

Case description: In this paper, we report a 58-year-old male with cough, back pain and increased sputum. He was diagnosed as LCNEC and SCLC in his lung successively. His tumor gradually progressed and combined LCNEC was then diagnosed in his cervical lymph node. Regimens of chemotherapy were accordingly adjusted several times, but his lesions were not relieved and he finally died.

Conclusions: Both LCNEC and SCLC have high aggressiveness. Some patients may have limited curative effect and poor prognosis when treated with chemotherapy even in combination with immune checkpoint inhibitors. Combined LCNEC may occur in extrapulmonary sites of some patients when the tumor progresses. Timely radiological evaluations are essential to identify changes of pulmonary and extrapulmonary lesions. Histopathological results including morphological features of malignant cells and immunohistochemical features of diseased tissues are more indispensable in establishing a confident diagnosis of lung neuroendocrine tumor and judging corresponding cellular types.

Keywords: Lung neuroendocrine tumor; case report; classification; pathology.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-21-2793/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Radiological and histopathological images in Aug 2020. (A) A soft tissue mass of right lung was shown in chest CT scan. (B) Inferior lobe of right lung tissues were positive for Syn in immunohistochemical staining (×400). (C) Inferior lobe of right lung tissues were positive for CD56 in immunohistochemical staining (×400). CT, computed tomography; Syn, synaptophysin.
Figure 2
Figure 2
Radiological and histopathological images in early Dec 2020. (A) Mass enlargement was shown in chest CT scan reevaluation. (B) Right distal bronchi tissues were positive for malignant cells with small size in hematoxylin-eosin staining (×100). (C) Right distal bronchi tissues were positive for Syn in immunohistochemical staining (×100). (D) Right distal bronchi tissues were positive for Ki-67 in immunohistochemical staining (×100). CT, computed tomography; Syn, synaptophysin.
Figure 3
Figure 3
Radiological and histopathological images in late Dec 2020. (A) Further enlargement of mass and worse lung lesions were shown in chest CT scan reevaluation. (B) Right cervical lymph node was positive for Syn in immunohistochemical staining (×200). (C) Right cervical lymph node was positive for Ki-67 in immunohistochemical staining (×200). CT, computed tomography; Syn, synaptophysin.
See this image and copyright information in PMC

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