Abstract
Background. A 61-year-old patient with no relevant medical or family history presented with a 2 month history of refractory dry cough that led to the diagnosis of typical carcinoid tumor of the lung metastatic to the mediastinal lymph nodes and liver. She initially received a long-acting somatostatin analog (octreotide) and chemotherapy with cisplatin and etoposide, which was ineffective.
Investigations. Physical examination, laboratory test, chromogranin A test, CT scan, 111In-diethylenetriaminepentaacetic acid (DTPA)-octreotide scan, 18F-FDG-PET scan, fine-needle and tissue core liver biopsies.
Diagnosis. Pulmonary spindle-cell carcinoid tumor with metastases to mediastinal lymph nodes and liver.
Management. Systemic treatment with oral capecitabine (1,500 mg/m2 daily from day 1 to day 21) and intravenous liposomal doxorubicin (10 mg/m2 on days 1, 8 and 15), both repeated every 4 weeks, administered concomitantly with long-acting octreotide 30 mg every 3 weeks. The patient achieved a significant and long-lasting response with the combination of capecitabine and liposomal doxorubicin. She reported no severe adverse effects.
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Acknowledgements
The authors thank Prof. Roberta Sarnelli, Dr. Angelo Bonadio, Dr. Vanna Zucchi and Dr. Umberto Simi of the Department of Pathology, Azienda USL6 of Livorno, Italy, for their help in the pathological description of the case. Written consent for publication was obtained from the patient's responsible relative. Charles P. Vega, University of California, Irvine, CA is the author of and is solely responsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.
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Masi, G., Fornaro, L., Cupini, S. et al. Refractory neuroendocrine tumor—response to liposomal doxorubicin and capecitabine. Nat Rev Clin Oncol 6, 670–674 (2009). https://doi.org/10.1038/nrclinonc.2009.148
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DOI: https://doi.org/10.1038/nrclinonc.2009.148
