Abstract
Background. In 1991, Travis et al. proposed a new category of large cell neuroendocrine carcinoma (LCNEC). Some investigators reported poor prognosis of LCNEC patients, with 5-year survival rates similar to small cell carcinoma. We report a case of LCNEC with aggressive progression after complete resection. Case. A 71-year-old man underwent left pneumonectomy and lymph node dissection for lung cancer on June 13, 2002. No finding suggested distant metastasis. The pathological diagnosis was large cell neuroendocrine carcinoma, T2N1M0, stage IIB. Two months after surgery, he presented with lumbago. Bone scintigram and magnetic resonance imaging revealed bone metastasis to the right sacroiliac joint. A brain metastasis was also detected by computed tomography. He received 30-Gy brain irradiation and 30-Gy bone radiotherapy to relieve the pain. Although the radiotherapy alleviated the pain, the brain and sacroiliac joint metastases did not shrink. The patient died of recurrent lung cancer 99 days after the surgical resection. Conclusion. We reported an aggressive progression case of pulmonary LCNEC. Prognosis and treatment efficacy in LCNEC patients remain controversial, and further investigation is needed.
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