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Publications

Case Reports Journal Article Epublish

PubMed: 42763668 DOI: 10.21037/med-2026-0018

A rare giant large cell neuroendocrine carcinoma: an ITMIG Tumor Board case report from a Turkish multidisciplinary team.

Mediastinum 10:42

Authors: Ayten Kayi Cangir, Serpil Dizbay Sak, Gökalp Güneş, Ayşegül Gürsoy Çoruh, Şebnem Dursun, Serap Akyürek, Elif Berna Köksoy, Dirk Van Raemdonck, Chad Strange, Andrea Arrossi, Anja C Roden, Arun Rajan, Ritsuko Komaki, Annemarie Shepherd

Affiliations

  • Department of Thoracic Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey.
  • Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey.
  • Department of Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
  • Department of Radiation Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey.
  • Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey.
  • ITMIG Tumor Board, Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
  • ITMIG Tumor Board, Department of Radiology, University of Texas, Austin, TX, USA.
  • ITMIG Tumor Board, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
  • ITMIG Tumor Board, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
  • ITMIG Tumor Board, Department of Medical Oncology, National Cancer Institute, Bethesda, MD, USA.
  • ITMIG Tumor Board, Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • ITMIG Tumor Board, Department of Radiation Oncology, University of Washington, Seattle, WA, USA.

Abstract

BACKGROUND

Large cell neuroendocrine carcinomas (LCNECs) of the thymus are rare, high-grade neuroendocrine neoplasms characterized by a high mitotic index and classified separately from thymomas, with markedly more aggressive behavior in terms of treatment response and prognosis. This study describes the treatment management of a patient who underwent surgery and received multimodal therapy for LCNEC.

CASE DESCRIPTION

A contrast-enhanced thoracic computed tomography (CT) scan of a 52-year-old male patient revealed an anterior mediastinal mass measuring approximately 14 cm × 16 cm, with areas of calcification and cystic components. Following transthoracic fine-needle aspiration biopsy, which was consistent with LCNEC, the patient received three cycles of neoadjuvant chemotherapy and subsequently underwent thymectomy via median sternotomy. Histopathological examination confirmed the diagnosis of LCNEC, after which adjuvant therapy was administered. The patient has remained disease-free during follow-up for 40 months.

CONCLUSIONS

LCNEC is an exceptionally rare subtype, accounting for only a very small proportion of all thymic epithelial tumors. Given the aggressive course of LCNEC and its potential for both local invasion and distant metastasis, a multimodal treatment approach is required. This treatment sequence represents a rational strategy consistent with previous studies advocating combined-modality management for advanced or recurrent thymic malignancies.

MeSH

Cells, Neoplasms, Combined Modality Therapy, Neuroendocrine Cells, Therapeutics, Carcinoma, Neuroendocrine