Large Cell Neuroendocrine Carcinoma of the Mediastinum with α-Fetoprotein Production

Takezawa, Ken; Okamoto, Isamu; Fukuoka, Junya; Tanaka, Kaoru; Uejima, Hisao; Yoon, Hyung Eun; Imakita, Masami; Fukuoka, Masahiro; Nakagawa, Kazuhiko

doi:10.1097/jto.0b013e3181623359

Cited by 15 publications

(6 citation statements)

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“…LCNEC is a rare form of cancer most frequently seen in the lung. Here, we report a case of LCNEC presenting in the anterior mediastinum associated with elevated AFP, which has only been reported in the literature once before (27). The differential for this tumor included lung adenocarcinoma extending into the mediastinum, SCLC, and other tumors of the anterior mediastinum: Thymoma, thymic carcinoma, lymphoma, and teratoma (28,29).…”

Section: Discussionmentioning

confidence: 91%

Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

et al. 2020

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Section: Discussionmentioning

confidence: 91%

Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

et al. 2020

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“…In 19 cases (82.6 %), tumor cells co‐express AFP with PIVKA‐II, while AFP production was not detected serologically and immunohistologically in our case. One case of AFP producing LCNEC of the mediastinum has been described in the English literature, and hepatoid differentiation was not confirmed in the tumor …”

Section: Discussionmentioning

confidence: 99%

Protein induced by vitamin K absence or antagonist II (PIVKA‐II) producing large cell neuroendocrine carcinoma (LCNEC) of lung with multiple liver metastases: A case report

Kurohama¹,

Mihara²,

Izumi³

et al. 2017

Pathology International

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A 78-year-old man was admitted to our hospital for multiple lung and liver tumors. Initial clinical diagnosis was hepatocellular carcinoma (HCC) with lung metastases because of a high value of serum protein induced by vitamin K absence or antagonist II (PIVKA-II) (6,705 mAU/mL). However, a review of a prior CT showed the lung tumor had existed 6 months before liver tumors were detected. The tumors progressed rapidly and the patient died 37 days after admission. Autopsy revealed that both lung and liver tumors exhibited the histology of large cell neuroendocrine carcinoma (LCNEC). Immunohistochemistry revealed that the tumor cells expressed not only neuroendocrine markers but also PIVKA-II diffusely. Hepatoid differentiation was not detected. Background liver did not show any chronic liver disease. The final diagnosis was PIVKA-II producing LCNEC of the lung with multiple liver metastases. PIVKA-II producing tumors other than HCC are extremely rare. To our best knowledge, this is the first case report of PIVKA-II producing neuroendocrine tumors of the lung.

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“…Surprisingly, histological findings in our patient showed small cell carcinoma with immunohistochemical positivity for AFP, which to the best of our knowledge has never been described occurring in the thymus. A literature search found two cases of AFP-positive thymic LCNEC, both of which were histologically diagnosed based on resected specimens, though the initial clinical diagnosis was germ cell carcinoma [ 4 , 5 ]. Chemotherapy is usually conducted for a germ cell carcinoma and its response rate is relatively high.…”

Section: Discussionmentioning

confidence: 99%

A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report

Kobayashi,

Funaki,

Fukui

et al. 2023

surg case rep

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Background An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encountered a patient with an AFP-positive small cell carcinoma and report here the clinical course. Case presentation A 40-year-old man was transferred to our hospital for a large anterior mediastinal tumor and showed an elevated serum AFP level. Computed tomography-guided biopsy results led to diagnosis of small cell carcinoma. Induction chemoradiotherapy was performed before surgery because of pulmonary artery invasion. The response to Induction chemoradiotherapy varied among sites, with the main tumor showing shrinkage and the metastasis site growth. This discrepancy suggested a histologic type unresponsive to or cancer cells potentially resistant to chemotherapy, thus a surgical re-biopsy was performed and histological findings revealed AFP-positive small cell carcinoma. Additional chemotherapy was performed, though could not control cancer progression, and the patient died 8 months after the first medical examination. Conclusions Our present clinical experience indicates the importance of histological examination for determining AFP-positive anterior mediastinal tumor treatment. Although AFP-positive neuroendocrine tumor of the thymus is relatively rarer than germ cell carcinoma, differential diagnosis with use of a histological examination should be considered because of the potentially poorer prognosis. The present clinical findings for an AFP-positive neuroendocrine tumor of the thymus case are considered useful for establishing an optimal treatment strategy in the future.

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Large Cell Neuroendocrine Carcinoma of the Mediastinum with α-Fetoprotein Production

Cited by 15 publications

References 10 publications

Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

Protein induced by vitamin K absence or antagonist II (PIVKA‐II) producing large cell neuroendocrine carcinoma (LCNEC) of lung with multiple liver metastases: A case report

A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report

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