Respir Case Rep. 2016; 5(3): 204-208 | DOI: 10.5505/respircase.2016.43660

Erken dönem göðüs duvarý metastazý oluþturan akciðerin büyük hücreli nöroendokrin karsinomu

Fazlý Yanýk¹, Yekta Altemur Karamustafaoðlu¹, Adem Karataþ¹, Ebru Taþtekin^2
1Trakya Üniversitesi Týp Fakültesi, Göðüs Cerrahisi Ana Bilim Dalý, Edirne
²Trakya Üniversitesi Týp Fakültesi, Patoloji Ana Bilim Dalý, Edirne

Akciðerin büyük hücreli nöroendokrin karsinomlarý (BHNK) yüksek gradeli tümörlerdir ve küçük hücreli akciðer kanserine(KHAK) benzer klinik ve biyolojik özellikler taþýrlar. Erken dönem göðüs duvarý metastazý oluþturan akciðerin bir BHNK’li olguyu tartýþmayý amaçladýk. Altmýþ iki yaþýnda erkek hastanýn toraks bilgisayarlý tomografisinde (BT) sol akciðer üst lob anterior segmentte 1,5 cm solid kitle izlendi. Pozitron emisyon tomografisinde kitle malign karakterdeydi. Peroperatuvar frozen sonucu; küçük hücreli dýþý akciðer kanseri (KHDAK) gelmesi üzerine sol üst lobektomi uygulandý. Sonuç gastrointestinal sistem kaynaklý p(T1aN0M0) nöroendokrin karsinom olarak raporlandý. Primer kaynaða yönelik yapýlan oktreotid sintigrafisi, gastroskopi, kolonoskopi, batýn-toraks BT’de bir patoloji saptanmadý. Olgunun 3. ay kontrolünde; göðüs duvarýnda kitle tespit edildi ve alýnan biyopsi BHNK metastazý olarak raporlandý. Olguya kemo-radyoterapi planlandý. Olgu tanýdan bir yýl sonra kaybedildi. BHNK’ler hýzlý metastaz yapabilen, agresif seyirli, nüks edebilen tümörler olduklarý için diðer KHDAK’lerinden ayrýlmasý önemlidir, bu hastalarda yakýndan takibe ihtiyaç vardýr.

Anahtar Kelimeler: Büyük hücreli nöroendokrin kanser, nöroendokrin tümörler, akciðer tümörleri.

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Large cell neuroendocrine carcinoma of lung with early chest wall metastasis

Fazlý Yanýk¹, Yekta Altemur Karamustafaoðlu¹, Adem Karataþ¹, Ebru Taþtekin^2
1Department Of Thoracic Surgery, Trakya University Faculty Of Medicine,edirne,turkey
²Department Of Pathology, Trakya University Faculty Of Medicine,edirne,turkey

The large cell neuroendocrine carcinomas of the lung (LCNEC) are high-grade tumors and they have similar clinical and biological characteristics of non-small cell lung cancer (NSCLC). We discuss a patient with LCNEC of the lung which early metastasis to chest wall. Sixty-two-year-old male patient had a 1.5 cm solid mass in left upper lob on computered tomography (CT). The mass was reported by positron emission tomography as malignant. Left upper lobectomy was applied in the same period, when perioperatively frozen-section result was diagnosed NSLC. Histopathological examination was revealed a neuroendocrine carcinoma, which may originate from the gastrointestinal tract p(T1AN0M0). The octreotide scintigraphy, gastroscopy, colonoscopy, abdominal, and chest CT were performed for primary origin, but did not reveal any pathology. Chest wall mass was detected postoperative third months and biopsy result was reported as large cell neuroendocrine carcinoma. Then, chemoradiotherapy was planned. Patient died after one year from diagnosis. Accurate differentiation of LCNEC from other types of NSCLC is important, and there is a need for close follow-up in these patients for aggressive and metastatic nature and recurrent disease.

Keywords: Large cell neuroendocrine carcinoma, neuroendocrine tumor, lung tumors.

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