Untalan Axle D, Arty Fnu, Khan Mahrukh A, Sirpal Vishakha, Shah Shazia M
Internal Medicine, Rutgers Health/Monmouth Medical Center, Long Branch, USA.
Cureus. 2024 Jul 3;16(7):e63781. doi: 10.7759/cureus.63781. eCollection 2024 Jul.
Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare but aggressive malignancy of the lung. Its nonspecific presentation and propensity for severe disease at the time of diagnosis create challenges in treatment. We report a case of an asymptomatic 61-year-old female who was incidentally found to have a pulmonary nodule after a fall. Upon further workup, she was found to have an aggressive LCNEC. The patient underwent a robotic-assisted left upper lobectomy, which was complicated by left lower lobe bronchus kinking and post-obstructive atelectasis, warranting further management by thoracic surgery. The patient additionally underwent video-assisted thoracoscopic surgery (VATS), open thoracotomy, pneumopexy, and bronchial stenting. This case highlights the need for strategies for early detection in at-risk populations. A multidisciplinary approach, which may involve both medical and surgical subspecialties, is essential in the management of this complex disease from the time of diagnosis to follow-up postoperatively to achieve the best clinical outcome.
肺大细胞神经内分泌癌（LCNEC）是一种罕见但侵袭性强的肺部恶性肿瘤。其非特异性表现以及诊断时易出现严重疾病的倾向给治疗带来了挑战。我们报告一例61岁无症状女性病例，该患者在跌倒后偶然发现肺部有结节。进一步检查后，发现她患有侵袭性LCNEC。患者接受了机器人辅助左上肺叶切除术，术后出现左下叶支气管扭结和阻塞性肺不张等并发症，需要胸外科进一步处理。患者还接受了电视辅助胸腔镜手术（VATS）、开胸手术、肺固定术和支气管支架置入术。该病例凸显了对高危人群进行早期检测策略的必要性。多学科方法，可能涉及医学和外科亚专业，对于从诊断到术后随访管理这种复杂疾病以实现最佳临床结果至关重要。
