A rare case of metastatic small cell neuroendocrine carcinoma of the lung presenting as isolated thrombocytopenia

Abstract

Small cell neuroendocrine carcinoma (SNEC) is a high grade and poorly differentiated neuroendocrine tumor which typically presents as a primary pulmonary neoplasm near the bronchial region. Due to the aggressive nature of the tumor, there are many ways it can initially present, mostly involving the lungs. We present a case of a 68-year-old male patient who initially presented with new-onset of severe thrombocytopenia with superimposed pneumonia. It was late in the progression of the disease that histopathology from the bone marrow confirmed SNEC, which presented only after it metastasized to the bone marrow by way of a rare paraneoplastic syndrome. Furthermore, the bone marrow biopsy revealed atypical markers not commonly seen in SNEC. Since this was such an atypical presentation of SNEC, management was limited to stabilization of the patient. The patient expired two weeks later.

A rare case of small-cell neuroendocrine tumour of the lung metastasising to the urinary bladder

“…The mean age at presentation is 65 years, and a strong association with heavy cigarette smoking is well known. 4 Although neuroendocrine tumours of the urinary bladder are much less common compared with lung neuroendocrine tumours, it is essential to consider this differential diagnosis in uropathology as this is central in guiding drug development and patient management. Bladder neuroendocrine tumours are less common than the other conventional histological genitourinary variants, namely urothelial carcinoma, adenocarcinoma and squamous cell carcinoma, constituting only 0.7% – 1% of malignant bladder cancers.…”