A Case of Combined Large Cell Neuroendocrine Carcinoma in a Young Male Patient

Abstract

Background. Combined large cell neuroendocrine carcinoma (LCNEC) is rare, and the clinical features and therapeutic strategy have not been yet established. We report a case of combined LCNEC in a young male patient that was initially interpreted as a pulmonary abscess. Case. A 36-year-old male patient presented with fever of two months duration and an abnormal shadow of the right lung. A medical examination revealed a high inflammatory reaction. He was diagnosed with a pulmonary abscess and treated with antibiotics but the treatment proved ineffective. Fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed a high uptake in the mass of the right upper lobe, and a bronchoscopic lung biopsy confirmed a diagnosis of non-small cell lung cancer. Right upper lobectomy with mediastinal lymph node dissection was performed. The postoperative pathological diagnosis was combined LCNEC and adenocarcinoma (pT3N0M0 Stage IIB). He became afebrile soon after resection and the inflammatory reaction normalized at one month after surgery. He received 4 cycles of adjuvant chemotherapy (CDDP+CPT-11). At present, he is alive without recurrence at 31 months after surgery. Conclusion. Surgery and adjuvant chemotherapy achieved a good result in the treatment of a young patient with combined LCNEC. Some studies have reported that the clinical features of combined LCNEC are similar to LCNEC; however, it is suggested that the coexisting tumor might affect the therapeutic strategy and the prognosis of combined LCNEC.