Adrenal neuroendocrine carcinoma not responsive to EP regimen (cisplatin and etoposide)

Abstract

Introduction: Neuroendocrine carcinoma is a malignant tumor that mostly occurs in the digestive tract and lungs but rarely occurs in the adrenal gland. It has a high degree of malignancy and poor prognosis. At present, there is lack of standard treatment protocols. Patient concerns: A 41-year-old woman presented with symptoms of repeated cough of one-month duration. Diagnosis: Laboratory tests, enhanced computed tomography imaging, and pathology confirmed the diagnosis of adrenal neuroendocrine carcinoma. Interventions: A chemotherapy regimen of cisplatin, etoposide (30 mg cisplatin d1–4+ 0.1 g etoposide d1–4) was formulated after multidisciplinary discussion. Outcomes: On the second day after the end of chemotherapy, the patient presented with bilateral lower extremity edema, decreased albumin, increased liver enzymes, new thrombus formation in the inferior vena cava and right external iliac vein, right pleural effusion and peritoneal effusion. Three episodes of convulsions of unknown cause occurred 22 days after the end of chemotherapy. L3 vertebral bone metastasis appeared 4 months after admission. Renal function deteriorated and multiple tumor metastases occurred throughout the body. The patient died 4 months and 10 days after admission. Conclusion: The prognosis of adrenal neuroendocrine carcinoma is extremely poor, and most patients have distant metastases. Chemotherapy regimens may be ineffective for some patients, and more clinical studies are needed to evaluate the effective treatment options.