1Pulmonologist, Lung Disease Research Center, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
2Internist, Lung Disease Research Center, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
3Internal Medicine Resident, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
4Pulmonologist, Internal Medicine Department, Bojnurd. North khorasan Medical University, Bojnurd, Iran
Primary neuroendocrine carcinoma (NEC) of the mediastinum is a rare type of carcinoma. According to the literature, only five cases of this condition have been reported so far. In this paper, we present a rare case of mediastinal NEC of unknown primary site. The patient was a 34-year-old man with mediastinal NEC, who presented with chronic dry cough and a right-sided mediastinal mass one year prior to hospital admission (winter 1391). His condition was confirmed by cervical lymph node biopsy. The patient refused to undergo chemotherapy treatment. During the hospital admission, the patient presented with severe dyspnea and signs of superior vena cava syndrome. Contrast-enhanced CT scan of the chest revealed a large heterogeneous mass extended from the right superior mediastinum to the right lung base with the encasement of the superior vena cava. After radiotherapy, the patient′s symptoms subsided and he underwent etoposide and cisplatin chemotherapy. After a 20-month patient follow-up, the subject remained alive and symptom-free.
Maeda A, Nakata M, Yasuda K, Yukawa T, Saisho S, Okita R, et al. Unknown primary large cell neuroendocrine carcinoma (LCNEC) in the mediastinum. Gen Thorac Cardiovasc Surg. 2013; 61:542–5.
Natsuhara A, Iwasaki Y, Minagawa T, Takemura Y, Nakanisi M, Nagata K, et al. Aggressively metastatic neuroendocrine carcinoma in the middle mediastinum. Nihon Kokyuki Gakkai Zasshi. 2001; 39:705-9.
Nojima D, Kiura K, Hotta K, Takigawa N, Tabata M, Tanimoto M. Large cell neuroendocrine carcinoma of the mediastinum. Nihon Kokyuki Gakkai Zasshi. 2010; 48:506-10.
Lukina O, Gorbunkov S, Dvorakovskaja I, Varlamov V, Akopov A. Fast-growing large cell neuroendocrine carcinoma of mediastinum. Ann Thorac Surg. 2011; 91:1618-20.
Stoyianni A,Pentheroudakis G,Pavlidis N. Neuroendocrine carcinoma of unknown primary: A systematic review of the literature and a comparative study with other neuroendocrine tumors. Cancer Treat Rev. 2011; 37:358-65.
Jimenez-Heffernan JA, Lopez-Ferrer P, Vicandi B, Mariño A, Tejerina E, Nistal M, et al. Fine-needle aspiration cytology of large cell neuroendocrine carcinoma of the lung: a cytohistologic correlation study of 11 cases. Cancer. 2008; 114:180-6.
Fernandez FG, Battafarano RJ. Large-cell neuroendocrine carcinoma of the lung. Cancer Control. 2006; 13:270.
Hiroshima K, Iyoda A, Shida T, Shibuya K, Iizasa T, Kishi H, et al. Distinction of pulmonary large cell neuroendocrine carcinoma from small cell lung carcinoma: a morphological, immunohistochemical, and molecular analysis. Mod Pathol. 2006; 19:1358-68.
Ree AH. Highly proliferative neuroendocrine carcinoma - influence of radiotherapy fractionation on tumor response. Radiat Oncol. 2008; 3:13.