Kapoor Mayank, Bedi Praneet, Sundriyal Deepak, Jain Ashita, Shriwastav Ujjawal, Sehrawat Amit
Department of Medical Oncology Hematology, All India Institute of Medical Sciences, Rishikesh, India.
Department of Medical Oncology, Max Superspeciality Hospital, Patparganj, New Delhi, India.
Case Rep Oncol Med. 2025 Mar 31;2025:2406678. doi: 10.1155/crom/2406678. eCollection 2025.
Large cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive cancer primarily found in the lungs but can also occur in other organs. It is characterized by rapid progression and high metastatic potential. We present a case of advanced-stage LCNEC lung in a patient with a poor performance status (PS), requiring oxygen support. Imaging revealed a large right upper lobe mass, lymphadenopathy, with bronchial encasement and invasion into the superior vena cava, leading to SVC syndrome and pleural effusion. Biopsy and immunohistochemistry confirmed LCNEC. Due to the patient's poor PS, treatment began with low-dose single-agent chemotherapy (carboplatin), followed by etoposide and cisplatin after improvement. Local radiation was also administered, and the treatment plan was adjusted to include atezolizumab. After 10 cycles, the patient achieved complete remission, sustained for 6 years. This case highlights the complexities of managing advanced LCNEC in a geriatric patient and the effectiveness of a multidisciplinary approach and immunotherapy.
大细胞神经内分泌癌（LCNEC）是一种罕见的侵袭性癌症，主要发生于肺部，但也可发生于其他器官。其特点是进展迅速且转移潜力高。我们报告一例晚期LCNEC肺癌患者，其体能状态（PS）较差，需要吸氧支持。影像学检查显示右上叶有一巨大肿块、淋巴结肿大，伴有支气管包绕及侵犯上腔静脉，导致上腔静脉综合征和胸腔积液。活检及免疫组化确诊为LCNEC。由于患者PS较差，治疗首先采用低剂量单药化疗（卡铂），病情改善后给予依托泊苷和顺铂。同时也进行了局部放疗，并调整治疗方案加入阿特珠单抗。10个周期后，患者实现完全缓解，并持续了6年。该病例凸显了老年晚期LCNEC患者管理的复杂性以及多学科方法和免疫治疗的有效性。
