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Pulmonary large-cell neuroendocrine carcinoma presenting as multiple cutaneous metastases.

Mestre T, Rodrigues AM, Cardoso J - J Bras Pneumol (2015 May-Jun)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Curry Cabral Hospital, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

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The histopathological examination of two nodules revealed strands and nests of large pleomorphic cells with vesicular nuclei and prominent nucleoli... Tumor cells were found to be immunohistochemically positive for chromogranin A, synaptophysin, and CD56 (Figure 2), as well as for cytokeratin 7, whereas they were immunohistochemically negative for CD20... A CT scan of the chest revealed a 4-cm mass in the left lower lobe (Figure 1)... The results of a transbronchial biopsy (via bronchoscopy) confirmed the diagnostic hypothesis of large-cell neuroendocrine carcinoma (LCNEC) of the lung... The neoplasms that most often present as cutaneous metastasis are breast cancer in women and lung carcinoma in men... Only 0.3% of all lung cancers are LCNECs, which rarely present as cutaneous metastasis... To our knowledge, ours is the first report of multiple cutaneous metastases as the presenting sign of LCNEC of the lung... Survival after cutaneous metastasis ranges from two to five months... It is important to distinguish cutaneous metastases of LCNEC from Merkel cell carcinoma, a rare lesion seen mainly in areas of the skin that have been exposed to the sun... In the latter, the cells are usually smaller and are cytokeratin 20-positive... The case presented here helps clarify the biological behavior and the immunohistochemical profile of LCNEC of the lung.

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Eruptive painful erythematous nodules on the face and scalp (photographs on the left). CT scans (on the right) revealed a 4-cm mass in the left lower lobe. Note the left adrenal gland metastasis (arrow).
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f01: Eruptive painful erythematous nodules on the face and scalp (photographs on the left). CT scans (on the right) revealed a 4-cm mass in the left lower lobe. Note the left adrenal gland metastasis (arrow).

Mentions: Here, we describe the case of a 66-year-old, male nonsmoker with a history of type 2 diabetes mellitus, hypertension, and dyslipidemia. The patient was referred to our hospital after the emergence of four painful erythematous nodules on his face, scalp, and trunk, over a three-week period (Figure 1). Determination of tumor markers showed elevated levels of procalcitonin (30.83 ng/mL; reference value, < 0.5 ng/mL), carbohydrate antigen 19-9 (2,700 U/mL; reference value, < 37 U/mL), and lactate dehydrogenase (850 U/L; reference range, 313-618 U/L). The histopathological examination of two nodules revealed strands and nests of large pleomorphic cells with vesicular nuclei and prominent nucleoli. Tumor cells were found to be immunohistochemically positive for chromogranin A, synaptophysin, and CD56 (Figure 2), as well as for cytokeratin 7, whereas they were immunohistochemically negative for CD20. A CT scan of the chest revealed a 4-cm mass in the left lower lobe (Figure 1). The results of a transbronchial biopsy (via bronchoscopy) confirmed the diagnostic hypothesis of large-cell neuroendocrine carcinoma (LCNEC) of the lung. The patient died three months after the diagnosis.


Pulmonary large-cell neuroendocrine carcinoma presenting as multiple cutaneous metastases.

Mestre T, Rodrigues AM, Cardoso J - J Bras Pneumol (2015 May-Jun)

Eruptive painful erythematous nodules on the face and scalp (photographs on the left). CT scans (on the right) revealed a 4-cm mass in the left lower lobe. Note the left adrenal gland metastasis (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541768&req=5

f01: Eruptive painful erythematous nodules on the face and scalp (photographs on the left). CT scans (on the right) revealed a 4-cm mass in the left lower lobe. Note the left adrenal gland metastasis (arrow).
Mentions: Here, we describe the case of a 66-year-old, male nonsmoker with a history of type 2 diabetes mellitus, hypertension, and dyslipidemia. The patient was referred to our hospital after the emergence of four painful erythematous nodules on his face, scalp, and trunk, over a three-week period (Figure 1). Determination of tumor markers showed elevated levels of procalcitonin (30.83 ng/mL; reference value, < 0.5 ng/mL), carbohydrate antigen 19-9 (2,700 U/mL; reference value, < 37 U/mL), and lactate dehydrogenase (850 U/L; reference range, 313-618 U/L). The histopathological examination of two nodules revealed strands and nests of large pleomorphic cells with vesicular nuclei and prominent nucleoli. Tumor cells were found to be immunohistochemically positive for chromogranin A, synaptophysin, and CD56 (Figure 2), as well as for cytokeratin 7, whereas they were immunohistochemically negative for CD20. A CT scan of the chest revealed a 4-cm mass in the left lower lobe (Figure 1). The results of a transbronchial biopsy (via bronchoscopy) confirmed the diagnostic hypothesis of large-cell neuroendocrine carcinoma (LCNEC) of the lung. The patient died three months after the diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Curry Cabral Hospital, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The histopathological examination of two nodules revealed strands and nests of large pleomorphic cells with vesicular nuclei and prominent nucleoli... Tumor cells were found to be immunohistochemically positive for chromogranin A, synaptophysin, and CD56 (Figure 2), as well as for cytokeratin 7, whereas they were immunohistochemically negative for CD20... A CT scan of the chest revealed a 4-cm mass in the left lower lobe (Figure 1)... The results of a transbronchial biopsy (via bronchoscopy) confirmed the diagnostic hypothesis of large-cell neuroendocrine carcinoma (LCNEC) of the lung... The neoplasms that most often present as cutaneous metastasis are breast cancer in women and lung carcinoma in men... Only 0.3% of all lung cancers are LCNECs, which rarely present as cutaneous metastasis... To our knowledge, ours is the first report of multiple cutaneous metastases as the presenting sign of LCNEC of the lung... Survival after cutaneous metastasis ranges from two to five months... It is important to distinguish cutaneous metastases of LCNEC from Merkel cell carcinoma, a rare lesion seen mainly in areas of the skin that have been exposed to the sun... In the latter, the cells are usually smaller and are cytokeratin 20-positive... The case presented here helps clarify the biological behavior and the immunohistochemical profile of LCNEC of the lung.

Show MeSH
Related in: MedlinePlus