Large-Cell Neuroendocrine Carcinoma of the Lung

Abstract

Accurate differentiation of LCNEC from other types of NSCLC is important because it identifies those patients at highest risk for developing recurrent disease. Efforts to identify effective adjuvant therapies are needed to improve treatment outcomes with this aggressive type of lung cancer.

Cardiothoracic manifestations of neuroendocrine tumours

“…60 In view of its aggressive behaviour, adjuvant chemoradiotherapy is generally used, although a definite advantage of post-operative adjuvant therapy has not been established. 56 SEER data describe 1-and 4-year survival of 76% and 41%, respectively-similar to that of LCC. 60 …”

“…Its incidence is not clearly defined, although reported between 2.8% and 3.5% within surgically resected cases. 56 It is strongly associated with smoking; LCNEC occurs in older age groups (6th-7th decade), with a mean age of 65 years and a male predilection. 35,56 Clinical features Clinical presentation varies from identification of an asymptomatic nodule to chest pain, non-specific flu-like symptoms, dyspnoea and night sweats.…”

“…Unlike other PNET subtypes, paraneoplastic syndromes have not been frequently observed in cases of LCNEC. 24,56,57 Disease is often advanced at diagnosis. 57 Histopathological diagnosis of LCNEC requires demonstration of specific criteria, which are as follows: NE morphology (organoid nesting, palisading or rosette-like structures) and non-small-cell cytological features (e.g.…”

“…56,58 Multidetector CT features are non-specific and similar to other NSCLC, consisting of a peripheral, well-defined, lobulated and heterogeneously enhancing soft-tissue mass. 59 Larger tumours typically demonstrate heterogeneous attenuation on enhanced studies owing to the characteristic patchy foci of necrosis, although smaller tumours may appear homogeneous in spite of this.…”

A case of confusion and bilateral temporal lesions in a young woman

“…The mean age of patients with LC-NEC ranges from 62 to 68 years and smoking appears to be a significant risk for development of LCNEC. 1 Large-cell neuroendocrine carcinoma of the lung has been associated with several paraneoplastic syndromes. These include a paraneoplastic retinopathy, 2 voltage-gated calcium channel antibody-mediated Lambert-Eaton syndrome, 3 and an anti-Hu-positive syndrome with painful sensory neuropathy, autonomic dysfunction, and tonic pupils.…”