sirolimus and Paraneoplastic-Syndromes

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.

Topics: Adrenal Gland Neoplasms; Adrenal Glands; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Bone Neoplasms; Calcitonin; Carcinoma, Bronchogenic; Carcinoma, Medullary; Carcinoma, Neuroendocrine; Cell Division; Female; Humans; Ki-67 Antigen; Liver; Liver Neoplasms; Lung; Lung Neoplasms; Middle Aged; Neoplasm Staging; Neoplasms, Multiple Primary; Octreotide; Paraneoplastic Syndromes; Sirolimus; Thyroid Gland; Thyroid Neoplasms