Zusammenfassung
Bei einer 53-jährigen Patientin, die seit 3 Jahren Reizhusten und Heiserkeit beklagte, wurde nach Biopsie einer proximalen bronchialen Raumforderung die Diagnose eines kleinzelligen neuroendokrinen Karzinoms der Lunge gestellt. Bei Progress unter Chemotherapie mit Etoposid und Cisplatin erfolgten eine Reevaluierung der primären Biopsie sowie weitere Biopsien von Metastasen in Leber und Nebenniere. Nun zeigte sich ein atypisches neuroendokrines Bronchialkarzinom. Unter Octreotidtherapie konnte ein weiterer Progress des atypischen neuroendokrinen Bronchialkarzinoms über 1 Jahr verhindert werden. Dann erfolgte bei diskretem Progress die Umstellung auf den mTOR-(„mammalian target of rapamycin“-)Inhibitor Everolimus. Anhand dieses Falls werden die diagnostischen Kriterien, prognostische Faktoren und Therapieoptionen bronchialer neuroendokriner Tumoren diskutiert.
Abstract
A 53-year-old female patient presented with cough and hoarseness for 3 years. Based on a biopsy of a bronchial tumor, a small cell neuroendocrine tumor of the lung was diagnosed and chemotherapy with etoposide and cisplatin was initiated. As the tumor progressed under chemotherapy, the bronchial biopsy was reevaluated and further biopsies of liver and adrenal metastases were obtained. The diagnosis was corrected, and an atypical neuroendocrine bronchial carcinoma was diagnosed. Under octreotide therapy, the patient remained stable for 1 year, when a discrete progress of the primary tumor in the lung was observed. Treatment with the mTOR (mammalian target of rapamycin) inhibitor everolimus was then initiated. Based on this case, the diagnostic criteria, prognostic factors and therapeutic options of neuroendocrine bronchial carcinomas are discussed.
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Böttger, C., Warth, A., Nawroth, P.P. et al. Neuroendokrines Karzinom der Lunge: eine diagnostische und therapeutische Herausforderung. Med Klin 105, 237–241 (2010). https://doi.org/10.1007/s00063-010-1049-z
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DOI: https://doi.org/10.1007/s00063-010-1049-z