Work

Exceptional long-term survival in pulmonary large-cell neuroendocrine carcinoma with brain metastases: a case report

Year: 2026

Type: article

Abstract: Background: Large-cell neuroendocrine carcinoma (LCNEC) of the lung is a rare and aggressive malignancy, with a poor prognosis and limited therapeutic options, particularly in advanced stages with brain metastases. Long-term survival in metastatic LCNEC is exceedingly uncommon. Case presentation: We report a case of a 32-year-old female diagnosed with stage IV pulmonary LCNEC in 2015. Over a 10-year disease course, she underwent a comprehensive, multimodal treatment approach, including chemotherapy, targeted therapy, two craniotomies, whole-brain radiotherapy, and resection of pelvic metastases. Serial imaging revealed prolonged stability of pulmonary lesions and dynamic control of brain metastases. Longitudinal monitoring of pro-gastrin-releasing peptide (PRO-GRP) levels showed a strong correlation with tumor progression. Molecular profiling identified RB1 and SDHD copy number loss, among other alterations. The patient remains alive 115 months after diagnosis and over 50 months after initial brain metastasis, representing one of the longest documented survivals in metastatic LCNEC. Conclusion: This case demonstrates that prolonged survival in stage IV LCNEC with brain metastases is possible through individualized multimodal therapy and close longitudinal monitoring. It underscores the potential value of molecular profiling and biomarkers like PRO-GRP in treatment planning and disease tracking.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2026.1631889

Authors: Bin Liu, Liangwen Zhang, Hua Wang

Institutions: Shandong Provincial Hospital, Shandong First Medical University

Language: English

Topic: Lung Cancer Research Studies

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801