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Large cell neuroendocrine carcinoma arising from the anterior mediastinum
  1. Annalisa Montebello1,
  2. Elizier Zahra Bianco2,
  3. Darko Babic3,
  4. Nicholas Paul Delicata2 and
  5. Neville Azzopardi2
  1. 1Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
  2. 2Gastroenterology, Mater Dei Hospital, Msida, Malta
  3. 3Histopathology, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Annalisa Montebello; a.montebello{at}


Anterior mediastinal large cell neuroendocrine carcinomas (LCNECs) are extremely rare, extremely aggressive malignancies that carry a dismal prognosis. We discuss a woman aged 60 years who presented with a 2-month history of recurrent severe constant epigastric pain. Abdominal examination revealed massive hepatomegaly and a CT scan of the liver confirmed coarse liver lesions. Histology from a liver biopsy was consistent with a large cell (non-small cell) neuroendocrine carcinoma. A CT scan of the chest showed a large anterior mediastinal mass unrelated to the lung, suggesting that the anterior mediastinum was the primary origin of the tumour. The patient was planned to receive platinum/etoposide chemotherapy for a metastatic mediastinal large cell neuroendocrine carcinoma. Unfortunately, her health deteriorated, and she was unfit to undergo any further treatment. She was treated palliatively and died 2 months after the diagnosis.

  • endocrine cancer
  • end of life decisions (palliative care)
  • radiology

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  • Contributors AM, EZB and NPD were responsible for writing up the clinical part of the case. DB took care of the histological details and figures. NA, the caring consultant physician offered constant guidance, supervision and final review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.