Lung neuroendocrine large cell carcinoma in young women. An unusual presentation

Introduction Lung neuroendocrine large cell carcinoma is a rare tumor with a poor prognosis. There are very few guidelines for treating this cancer but a better knowledge of its markers could improve the treatment and the prognosis. Observations We report two patients who presented initially with an early stage carcinoid tumor treated with surgery. Both patients had further new neuroendocrine disease diagnosed because of intermittent carcinoid syndrome, predominantly occurring at the same time as menstruation. They were then diagnosed with metastatic lung neuroendocrine large cell carcinoma and treated with first-line cisplatin–etoposide and second-line octreotide with estrogen plus progestin. They both had a good prognosis with no disease progression to date. Conclusions The clinical characteristics of these cases raise several questions about the pathophysiology of lung neuroendocrine large cell carcinoma and may suggest potential new treatment options. The unusual clinical presentation and good prognosis may be explained either by the second-line treatment choice or by potential molecular or hormonal biomarkers. There is a need to investigate these potential biomarkers further since they could be new therapeutic targets.