Video-assisted thoracic surgery right sleeve lobectomy.

Area of Science:

• Thoracic Surgery
• Oncology
• Pulmonology

Background:

• Large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive form of lung cancer.
• Surgical intervention, particularly minimally invasive approaches, is a key treatment modality for resectable LCNEC.
• Smoking is a primary risk factor for lung cancer, including LCNEC.

Purpose of the Study:

• To report a case of successful surgical management of a large cell neuroendocrine carcinoma (LCNEC) using video-assisted thoracic surgery (VATS).
• To highlight the perioperative course and outcomes following VATS RUL lobectomy for LCNEC.
• To evaluate the efficacy of adjuvant chemotherapy in preventing recurrence in LCNEC.

Main Methods:

• A 50-year-old male smoker with a right upper lobe mass underwent bronchoscopy, revealing large cell neuroendocrine carcinoma (LCNEC).
• Preoperative staging included CT, ECT, abdominal US, and brain MR, confirming clinical stage cT2bN0M0 (IIA).
• The patient underwent selective VATS right upper lobe (RUL) lobectomy with mediastinal lymph node dissection after 9 days of smoking cessation.

Main Results:

• The VATS procedure was completed smoothly in 200 minutes with minimal blood loss (150 mL).
• Postoperative pathology confirmed RUL LCNEC, pT2bN0M0R0 (IIA stage).
• The patient was discharged 11 days post-operation and remains alive and disease-free after four cycles of EP adjuvant chemotherapy.

Conclusions:

• Video-assisted thoracic surgery (VATS) is a feasible and effective minimally invasive approach for resectable large cell neuroendocrine carcinoma (LCNEC).
• Early diagnosis, appropriate staging, and smoking cessation are crucial for successful surgical outcomes in LCNEC patients.
• Adjuvant chemotherapy may play a role in preventing recurrence in patients with resected LCNEC.