B80-5-07 A Rare Case of Lung Neuroendocrine Tumor Mimicking Complicated Pneumonia
Abstract
Pulmonary neuroendocrine tumors (NETs) represent a small fraction of lung cancers, accounting for about 1 to 2% of adult cases and roughly a quarter of all NETs. Their symptoms are often vague and overlap with common respiratory illnesses, which can delay diagnosis. In patients with presumed pneumonia who do not improve despite appropriate therapy, alternative causes such as underlying malignancy should be considered.
A 55-year-old Hispanic male with a history of chronic atrial fibrillation, hypertension, diabetes mellitus, prior cerebrovascular accident with residual right hemiparesis, and a five-pack-year smoking history presented with a 2-day history of productive cough, shortness of breath, generalized malaise, and weakness. He was started on oral levofloxacin by his primary care physician for suspected community-acquired pneumonia. Despite mild improvement, fever and dyspnea persisted, prompting hospitalization. On arrival, he appeared mildly dyspneic. The lung examination revealed diminished breath sounds over the left lung field. Chest computed tomography (Figure, Panel A) demonstrated a large mediastinal and left upper lobe mass with a left pleural effusion, raising suspicion for an underlying neoplasm. Empiric broad-spectrum intravenous antibiotics were started for presumed complicated pneumonia. Subsequent core biopsy of the mass (Figure, Panel B) confirmed a high-grade small cell neuroendocrine carcinoma. Staging studies revealed localized disease, and oncology…
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