Hypertrophic pulmonary osteoarthropathy, secretory diarrhea and pancoast syndrome in the setting of a large cell neuroendocrine carcinoma of the lung: A case report

Carley Mitchell , Leyla Bayat , Wadad Mneimneh , Debora Bruno
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Abstract

Large cell neuroendocrine carcinoma of the lung is a rare and aggressive pulmonary malignancy. Given its peripheral location, patients are frequently asymptomatic at the time of diagnosis or present with non-specific complaints. Moreover, its association with paraneoplastic syndromes or structural intrathoracic complications are highly atypical. Here, we report a case involving a 57-year-old female who presented with two simultaneous paraneoplastic syndromes, including hypertrophic pulmonary osteoarthropathy and secretory diarrhea, prior to the diagnosis of an early-stage large cell neuroendocrine carcinoma of the lung. Both syndromes showcased rapid symptomatic resolution following tumor resection. Upon disease recurrence, the patient developed a presentation consistent with Pancoast syndrome, with gradual improvement following the initiation of chemoradiotherapy. Individually, these conditions are rarely reported in association with large cell neuroendocrine carcinoma of the lung making their combination highly unusual. Furthermore, related symptoms were present both before and at the time of diagnosis, and upon disease recurrence. This highlights the importance of maintaining a high clinical suspicion for atypical manifestations of malignancy.

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肺大细胞神经内分泌癌的增生性肺骨关节病、分泌性腹泻和Pancoast综合征1例报告
摘要肺大细胞神经内分泌癌是一种罕见的侵袭性肺恶性肿瘤。鉴于其外周位置,患者在诊断时通常无症状或表现为非特异性主诉。此外,它与副肿瘤综合征或结构性胸内并发症的关联是高度不典型的。在此,我们报告一例57岁女性患者,在诊断为早期肺大细胞神经内分泌癌之前,同时出现两种副肿瘤综合征,包括肥厚性肺骨关节病和分泌性腹泻。两种症状均显示肿瘤切除后症状迅速缓解。疾病复发后,患者出现与Pancoast综合征一致的表现,在开始放化疗后逐渐改善。单独来看,这些情况很少与肺大细胞神经内分泌癌相关,因此它们的合并非常不寻常。此外,在诊断前和诊断时以及疾病复发时均存在相关症状。这突出了对恶性肿瘤的非典型表现保持高度临床怀疑的重要性。
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0.40
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审稿时长
96 days
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