Rare lung cancer subtype discovery by bone metastases: Synchronous traits

This study investigates the synchronous traits of a rare lung cancer subtype, specifically Large Cell Neuroendocrine Carcinoma (LCNEC), discovered through bone metastases. Bone metastases are a common occurrence in lung cancer, significantly impacting the quality of life and survival of patients. Synchronous bone metastasis (SBM), defined as bone metastases diagnosed within three months of lung cancer diagnosis, and metachronous bone metastasis (MBM), diagnosed more than three months after lung cancer diagnosis, exhibit distinct clinicopathological characteristics, therapeutic sensitivities, and prognostic outcomes. This article presents a visual case discussion of a 64-year-old male patient who experienced a pathological fracture of the proximal femur, leading to the incidental discovery of LCNEC through bone biopsy. Further imaging and diagnostic tests confirmed the presence of a primary lung tumor and bone metastases. The treatment approach for LCNEC remains challenging due to limited data and varying outcomes reported in the literature, however our patient received cisplatin with etoposide chemotherapy following fracture management. The findings emphasize the importance of recognizing rare lung cancer subtypes, such as LCNEC, through bone metastases and tailoring individualized treatment plans.