[Neuroendocrine carcinoma of the lung: a diagnostic and therapeutic challenge].
A 53-year-old female patient presented with cough and hoarseness for 3 years. Based on a biopsy of a bronchial tumor, a small cell neuroendocrine tumor of the lung was diagnosed and chemotherapy with etoposide and cisplatin was initiated. As the tumor progressed under chemotherapy, the bronchial biopsy was reevaluated and further biopsies of liver and adrenal metastases were obtained. The diagnosis was corrected, and an atypical neuroendocrine bronchial carcinoma was diagnosed. Under octreotide therapy, the patient remained stable for 1 year, when a discrete progress of the primary tumor in the lung was observed. Treatment with the mTOR (mammalian target of rapamycin) inhibitor everolimus was then initiated. Based on this case, the diagnostic criteria, prognostic factors and therapeutic options of neuroendocrine bronchial carcinomas are discussed.
Böttger
Claudia
C
Innere Medizin I und Klinische Chemie, Universität Heidelberg, Heidelberg, Germany.
Warth
Arne
A
Nawroth
Peter P
PP
Isermann
Berend
B
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D000311:Adrenal Glands / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary; D002116:Calcitonin / Q000378:metabolism; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary*; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D002455:Cell Division / Q000502:physiology; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D015282:Octreotide / Q000008:administration & dosage; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D020123:Sirolimus / Q000008:administration & dosage; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D002116:Calcitonin; D015282:Octreotide; D020123:Sirolimus
Nucl Med Commun. 2009 Apr;30(4):281-6
19247211
Clin Cancer Res. 2008 Jan 1;14(1):149-54
18172265
Thorac Cardiovasc Surg. 2005 Jun;53(3):168-72
15926097
Am J Clin Oncol. 1997 Jun;20(3):285-8
9167755
Ann Thorac Surg. 2004 May;77(5):1781-5
15111186
Eur J Cardiothorac Surg. 2002 May;21(5):883-7
12062280
Ann Thorac Surg. 2009 Oct;88(4):1350-2
19766843
J Clin Oncol. 2008 Jul 10;26(20):3403-10
18612155
J Thorac Oncol. 2008 Dec;3(12):1410-5
19057265
Clin Nucl Med. 2009 Jul;34(7):459-61
19542957
J Thorac Cardiovasc Surg. 2007 Apr;133(4):973-8
17382637
J Thorac Cardiovasc Surg. 1994 Jan;107(1):1-6; discussion 6-7
8283871
J Clin Oncol. 2009 Oct 1;27(28):4656-63
19704057
Isr Med Assoc J. 2005 Nov;7(11):712-6
16308994
Chest. 2006 Nov;130(5):1405-11
17099017
Cancer. 2008 Jul 1;113(1):5-21
18473355
Chest. 2001 Jun;119(6):1647-51
11399686
J Clin Endocrinol Metab. 2009 Feb;94(2):428-33
19017754
Eur J Gastroenterol Hepatol. 2007 Dec;19(12):1154-9
17998844
Cancer. 2003 Feb 15;97(4):934-59
12569593
Lung Cancer. 2002 Aug;37(2):127-35
12140134
J Clin Oncol. 2010 Jan 1;28(1):69-76
19933912
Chest. 2001 Apr;119(4):1143-50
11296182
Am J Surg Pathol. 1998 Aug;22(8):934-44
9706973