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Primary pleural small cell carcinoma with massive pleural effusion: A rare case report
Punam Rabha1, Jerryes Pious Wisely1, Ashutosh Jain1
1Department of Medical Oncology, Fortis Memorial Research Institute, Gurugram, India.
International Journal of Surgery Case Reports
|May 22, 2025
Summary
Primary pleural small cell carcinoma is a rare and aggressive lung cancer variant. Early diagnosis and treatment are crucial for managing this challenging condition.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Small cell lung carcinoma (SCLC) is a leading cause of cancer mortality.
- Primary pleural small cell carcinoma is an exceptionally rare variant of SCLC.
- Atypical presentations of pleural SCLC pose diagnostic challenges.
Observation:
- A 70-year-old male presented with dyspnea and weight loss, showing massive pleural effusion on imaging.
- Pleural fluid analysis and immunohistochemistry confirmed small cell neuroendocrine carcinoma.
- Tumor cells exhibited high proliferation (Ki-67 >90%) and specific markers (pancytokeratin, TTF1, synaptophysin, INSM1).
Findings:
- Diagnosis of primary pleural small cell carcinoma was confirmed via cytological and immunohistochemical analyses.
- The tumor demonstrated aggressive, highly proliferative characteristics.
- Systemic chemotherapy (Carboplatin and Etoposide) resulted in a partial response.
Implications:
- Accurate diagnosis is vital to differentiate pleural SCLC from other malignancies like mesothelioma.
- Management aligns with standard SCLC protocols, emphasizing chemotherapy.
- Prompt diagnosis and intervention can lead to disease control in rare pleural SCLC cases.
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