Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
Gastroenterology, Mater Dei Hospital, Msida, Malta.
BMJ Case Rep. 2021 May 25;14(5):e240453. doi: 10.1136/bcr-2020-240453.
Anterior mediastinal large cell neuroendocrine carcinomas (LCNECs) are extremely rare, extremely aggressive malignancies that carry a dismal prognosis. We discuss a woman aged 60 years who presented with a 2-month history of recurrent severe constant epigastric pain. Abdominal examination revealed massive hepatomegaly and a CT scan of the liver confirmed coarse liver lesions. Histology from a liver biopsy was consistent with a large cell (non-small cell) neuroendocrine carcinoma. A CT scan of the chest showed a large anterior mediastinal mass unrelated to the lung, suggesting that the anterior mediastinum was the primary origin of the tumour. The patient was planned to receive platinum/etoposide chemotherapy for a metastatic mediastinal large cell neuroendocrine carcinoma. Unfortunately, her health deteriorated, and she was unfit to undergo any further treatment. She was treated palliatively and died 2 months after the diagnosis.
前纵隔大细胞神经内分泌癌（LCNEC）极为罕见，是侵袭性极强的恶性肿瘤，预后极差。我们讨论了一位 60 岁女性，她因反复发作的严重持续上腹痛就诊，病史为 2 个月。腹部检查发现肝肿大，肝脏 CT 扫描证实肝内有粗结节。肝活检组织学检查符合大细胞（非小细胞）神经内分泌癌。胸部 CT 扫描显示前纵隔有一个与肺部无关的大肿块，提示前纵隔是肿瘤的原发部位。该患者计划接受顺铂/依托泊苷化疗治疗纵隔转移大细胞神经内分泌癌。不幸的是，她的健康状况恶化，无法进行进一步治疗。她接受姑息治疗，在诊断后 2 个月死亡。
