Abstract
Pulmonary neuroendocrine neoplasms (NENs) are classified into neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). NETs comprise typical carcinoids (TC) and atypical carcinoids (AC), while NEC are classified into large-cell neuroendocrine carcinomas (LCNEC) and small-cell neuroendocrine carcinomas (SCLC). NETs and NECs are distinct lesions, without molecular overlap, and with different prognosis and therapeutic options. We present the case of a 65-year-old patient diagnosed with pulmonary AC, marking its debut with carcinoid syndrome in 2016. The peculiarity of this case is given by the secondary bone lesions in progression, highlighted by CT examinations, without expressing somatostatin receptors or increased metabolic activity, which leaves open the possibility of dedifferentiation or a metachronous tumor.
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