Rupture of a large cell neuroendocrine carcinoma, causing early local recurrence

We present a case of large cell neuroendocrine carcinoma (LCNEC) requiring an urgent operation due to a rupture-induced shock. Primary lung cancers rarely rupture. This event could have spread malignant cells. Our patient died of pleural dissemination at day 81 after the operation. We had difficulty diagnosing the lesion before rupture despite various examinations including biopsy. In cases of a large, growing, cavitating mass, we should consider the possibility of malignant tumor, and a surgical approach to prevent rupture. A ruptured malignant tumor may also be treated by adjuvant therapy rather than resection.