Combined large cell neuroendocrine carcinoma of the lung: case report with brief review

Large cell neuroendocrine carcinoma (LCNEC) in the lung is an uncommon and highly aggressive type of histological variation, representing only a small percentage of all lung cancer cases. The occurrence of combined LCNEC, distinguished by the coexistence of neuroendocrine and non-neuroendocrine elements within a single tumor, is even more infrequent. A 49-year-old male presented with lytic lesion of the mandible with suspected lung metastasis. Biopsy of the mandibular lesion was reported as ameloblastic fibroma. The biopsy of the lung lesion turned out to be combined LCNEC of the lung. Further positron emission tomography (PET) evaluation showed multiple metastatic deposits in bilateral lungs, mediastinal nodes, liver, bone, adrenal, and kidney. The patient has received seven cycles of paclitaxel and carboplatin with decrease in size of nodes and lesion post 6 months. Herein, we report a case of combined LCNEC with lung adenocarcinoma which is infrequently encountered and has been a subject of research with a brief review of literature.