2021 Volume 43 Issue 3 Pages 261-265
Background. Large cell neuroendocrine carcinoma arising from a bronchus is rare. Case. A 68-year-old man presented to our institution complaining of sudden dyspnea. A clinical examination revealed a mass occluding the left main bronchus. His history included right nephroureterectomy for papillary urothelial carcinoma of the right renal pelvis that had been performed 1 year previously. At the present admission, a clinical examination suggested a mass occluding the left main bronchus. Chest computed tomography confirmed the mass occluding the left main bronchus and showed enlargement of the subtracheal and right axillary lymph nodes. Bronchoscopy showed a tumor, extending from the bifurcation, which occluded the left main bronchus. Metastasis from the prior renal pelvic cancer was suspected. Because the present tumor bled easily, there was a risk of lung aspiration and airway obstruction, which precluded biopsy evaluation. The tumor was pedunculated, and was therefore endoscopically resected using an electrosurgical snare followed by placement of a Dumont Y stent. The pathological diagnosis was large cell neuroendocrine carcinoma in the left main bronchus, which was considered to be the primary lesion. Chemotherapy (carboplatin and irinotecan hydrochloride) was administered. At the 14-months follow-up examination, the tumor was controlled, with no increase in growth. Conclusion. Large cell neuroendocrine carcinoma arising from a bronchus is rare. We reported a case that was treated with endoscopic tumor resection and stent placement followed by postoperative chemotherapy.
