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Prophylactic cranial irradiation (PCI) was recommended for limited‐stage small‐cell lung cancer (SCLC) patients with complete or partial response to primary chemoradiotherapy. But it is still controversial regarding its role in SCLC patients who have had radical resection. This meta‐analysis aims to evaluate the efficacy of PCI in resected SCLC patients. We searched PubMed, EMBASE, Web of Science, CENTRAl, and ClinicalTrials for controlled trials and cohort studies regarding PCI in postoperative SCLC patients. The correlation between PCI and post‐operative outcomes in SCLC patients, including survival and brain metastasis rate (BMR), was examined using hazard ratios (HRs) and risk ratios with corresponding 95% confidence intervals. Quality of studies was assessed by the Newcastle–Ottawa Scale (NOS), and publication bias was assessed by Begg's test. Meta‐analysis of eight studies with 2688 patients in total showed PCI was associated with improved overall survival (OS) for resected SCLC (HR: 0.65, 95% CI: 0.57–0.75, p < 0.01). In addition, subgroup analysis on three studies including 923 patients confirmed the protective role of postoperative PCI in N0 SCLC patients (HR: 0.79, 95% CI: 0.61–0.97, p < 0.05). There was also a significant reduction in BMR in the PCI group pooled from six studies (HR: 0.58, 95% CI: 0.40–0.85, p < 0.01). The use of PCI delayed brain recurrence and improved OS in patients with resected, stage I‐III SCLC. Importantly, patients with N0 SCLC can also benefit from postoperative PCI. In future studies, PCI's role in patients with resected N0 SCLC at different T stage may need to be explored. [ABSTRACT FROM AUTHOR]

Skull base metastases, including those from small‐cell lung carcinoma (SCLC), can present with various syndromes depending on the site of involvement, such as orbital syndrome, parasellar syndrome, middle fossa syndrome, jugular foramen syndrome, and occipital condyle syndrome (OCS). One such example is OCS, which consists of unilateral occipital headache accompanied with ipsilateral hypoglossal palsy. This case report describes a 51‐year‐old man initially diagnosed with OCS, which led to the discovery of systemic bone metastases from SCLC. Magnetic resonance imaging showed lesions in the occipital condyle and hypoglossal canal, while positron emission tomography‐computed tomography identified a lung mass and widespread metastases. SCLC is highly aggressive and metastatic, with the bone being a common site of spread. In this case, the OCS preceded the diagnosis of the underlying malignancy. Prompt diagnosis and treatment are crucial, as patients with OCS often have advanced disease. This case highlights the importance of considering SCLC as a potential etiology for OCS, given the propensity for bone metastases. Early recognition and evaluation of OCS is essential to initiate appropriate management. [ABSTRACT FROM AUTHOR]

Diabetes insipidus (DI) is a disorder of water hemostasis that is associated with polyuria-polydipsia syndrome. Central DI (CDI) primarily results from autoimmune destruction, traumatic injury, or anatomical damage caused by neoplasms. Craniopharyngioma, germinoma, and distant metastases are the main neoplastic causes, with pituitary adenomas rarely manifesting as CDI. Pituitary gland metastasis is rare, with the vast majority of cases being asymptomatic. We present a rare case of pituitary metastasis originating from small-cell carcinoma of the lung with CDI and skin swellings as the primary manifestation, without any evidence of the primary malignancy upon initial presentation. A 56-year-old chronic smoker with newly diagnosed type-2 diabetes mellitus presented with a history of polydipsia and polyuria along with soft tissue swellings in the axilla and the chest for the last 3 months. A water deprivation test and a desmopressin challenge test were performed, revealing the presence of CDI. In light of the CDI, a contrast-enhanced magnetic resonance imaging brain was performed, which displayed a loss of pituitary bright spot and four T2 isointense lesions with post-contrast enhancement in the left frontal, parietal, occipital, and right temporal lobes, suggestive of metastatic lesions. Fine needle aspiration cytology of the swelling revealed cytomorphological characteristics indicating the presence of malignancy, specifically favoring carcinoma. Contrast-enhanced computed tomography thorax revealed a right hilar lung mass infiltrating the surrounding structures with multiple regional and distant metastases. A lung biopsy confirmed the presence of small-cell lung carcinoma (SCLC). The final diagnosis was advanced SCLC with multiple distant metastases associated with CDI, and the patient is currently receiving palliative care and inhalational desmopressin. In conclusion, metastatic lesions and lung cancer must be considered early when patients present with polydipsia and polyuria symptoms.

Background: Lung cancer, particularly small-cell lung carcinoma (SCLC), often presents with respiratory symptoms. However, atypical manifestations including jaundice and abdominal pain can obscure the diagnosis, leading to challenges in early detection and treatment. Case Presentation: A 49-year-old male, with a history of smoking and diagnosed with Chronic Obstructive Pulmonary Disease (COPD), presented to the emergency department with a 3-day history of jaundice and a 3-week duration of mild abdominal pain. Initial investigations, including blood tests, showed hyperbilirubinemia and elevated lipase and amylase levels. An abdominal ultrasound was performed and revealed a hypoechoic, inhomogeneous mass in the head of the pancreas and multiple liver masses, suggesting a cephalo-pancreatic formation with liver metastasis. Further diagnostic procedures, including upper endoscopy and ERCP, followed by a TAP CT scan, identified a large mediastinal-pulmonary mass with invasion into major vessels and extensive metastasis. The immunohistochemical analysis of a duodenal ulcer biopsy confirmed a diagnosis of duodenal metastasis from a small-cell neuroendocrine lung carcinoma. Conclusion: Our case highlights that while rare, the possibility of metastatic spread should be included in the differential diagnosis when obstructive jaundice occurs in the context of high-risk factors for lung cancer. [ABSTRACT FROM AUTHOR]

Aims: Cytoplasmic p53 expression indicates a high frequency of TP53 abnormalities in gynaecological carcinoma. However, the implication of this expression in pulmonary neuroendocrine carcinoma (NEC) remains unclear. Thus, our study aimed to fill this research gap. Methods and results: Immunohistochemistry (IHC) of p53 was performed on 146 cases of resected small‐cell lung carcinoma and large‐cell NEC, and next‐generation sequencing was conducted on cases showing cytoplasmic and wild‐type p53 expression. IHC revealed overexpression in 57% of the cases (n = 83), complete absence in 31% (n = 45), cytoplasmic expression in 8% (n = 12) and wild‐type expression in 4% (n = 6) of the cases. TP53 mutations were identified in nine of the 13 cases with available genetic analysis. The TP53 mutation rates in cases with cytoplasmic and wild‐type p53 expression were 88% (seven of eight) and 40% (two of five), respectively. All seven cases showing cytoplasmic expression with TP53 mutations harboured loss‐of‐function type mutations: four had mutations in the DNA‐binding domain, two in the nuclear localisation domain and one in the tetramerisation domain. Clinically, cases with cytoplasmic p53 expression had a poor prognosis similar to that in cases with p53 overexpression or complete absence. Conclusions: Cytoplasmic p53 expression in patients with pulmonary NEC suggests a high TP53 mutation rate, which is associated with a poor prognosis similar to that in patients with p53 overexpression or complete absence. This cytoplasmic expression should not be misidentified as a wild‐type expression. This is the first report, to our knowledge, that demonstrates the implication of cytoplasmic p53 expression in pulmonary NEC. [ABSTRACT FROM AUTHOR]

Fundamental studies on biomarkers as well as developed assays for their detection can provide valuable information facilitating clinical decisions. For patients with lung cancer, there are established circulating biomarkers such as serum progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and cytokeratin-19 fragment (CYFRA21-1). There are also molecular biomarkers for targeted therapy such as epidermal growth factor receptor (EGFR) gene, anaplastic lymphoma kinase (ALK) gene, KRAS gene, and BRAF gene. However, there is still an unmet need for biomarkers that can be used for early detection and predict treatment response and survival. In this review, we describe the lung cancer biomarkers that are currently being used in clinical practice. We also discuss emerging preclinical and clinical studies on new biomarkers such as omics-based biomarkers for their potential clinical use to detect, predict, or monitor subtypes of lung cancer. Additionally, between-method differences in tumor markers warrant further development and improvement of the standardization and harmonization for each assay. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate whether whole‐brain radiotherapy (WBRT) decreases lymphocyte counts and evaluate the impact of treatment‐related lymphopenia on survival in patients with brain metastasis. Methods Medical records from 60 small‐cell lung cancer patients treated with WBRT from January 2010 to December 2018 were included in the study. Total lymphocyte count (TLC) was obtained pre and post treatment (within 1 month). We performed linear and logistic regression analyses to identify predictors of lymphopenia. The association between lymphopenia and survival was analyzed using Cox regression analysis. Results Thirty‐nine patients (65%) developed treatment‐related lymphopenia. The median TLC decrease was −374 cells/μL (interquartile range −50 to −722, p

Background: Lung cancer, particularly small-cell lung carcinoma (SCLC), often presents with respiratory symptoms. However, atypical manifestations including jaundice and abdominal pain can obscure the diagnosis, leading to challenges in early detection and treatment. Case Presentation: A 49-year-old male, with a history of smoking and diagnosed with Chronic Obstructive Pulmonary Disease (COPD), presented to the emergency department with a 3-day history of jaundice and a 3-week duration of mild abdominal pain. Initial investigations, including blood tests, showed hyperbilirubinemia and elevated lipase and amylase levels. An abdominal ultrasound was performed and revealed a hypoechoic, inhomogeneous mass in the head of the pancreas and multiple liver masses, suggesting a cephalo-pancreatic formation with liver metastasis. Further diagnostic procedures, including upper endoscopy and ERCP, followed by a TAP CT scan, identified a large mediastinal-pulmonary mass with invasion into major vessels and extensive metastasis. The immunohistochemical analysis of a duodenal ulcer biopsy confirmed a diagnosis of duodenal metastasis from a small-cell neuroendocrine lung carcinoma. Conclusion: Our case highlights that while rare, the possibility of metastatic spread should be included in the differential diagnosis when obstructive jaundice occurs in the context of high-risk factors for lung cancer.

Background: To investigate whether whole‐brain radiotherapy (WBRT) decreases lymphocyte counts and evaluate the impact of treatment‐related lymphopenia on survival in patients with brain metastasis. Methods: Medical records from 60 small‐cell lung cancer patients treated with WBRT from January 2010 to December 2018 were included in the study. Total lymphocyte count (TLC) was obtained pre and post treatment (within 1 month). We performed linear and logistic regression analyses to identify predictors of lymphopenia. The association between lymphopenia and survival was analyzed using Cox regression analysis. Results: Thirty‐nine patients (65%) developed treatment‐related lymphopenia. The median TLC decrease was −374 cells/μL (interquartile range −50 to −722, p < 0.001). Baseline lymphocyte count was a significant predictor of TLC difference and percentage change in TLC. Logistic regression analysis found male sex (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.00–0.79, p = 0.033) and higher baseline lymphocyte count (OR 0.91, 95% CI 0.82–0.99, p = 0.005) were associated with a lower risk of developing ≥grade 2 treatment‐related lymphopenia. Cox regression analysis showed that age at brain metastasis (hazard ratio [HR] 1.03, 95% CI 1.01–1.05, p = 0.013), ≥grade 2 treatment‐related lymphopenia, and percentage change in TLC (per 10%, HR 0.94, 95% CI 0.89–0.99, p = 0.032) were prognostic factors of survival. Conclusions: WBRT decreases TLC and the magnitude of treatment‐related lymphopenia is an independent predictor of survival in small‐cell lung cancer patients. [ABSTRACT FROM AUTHOR]

Abstract Background The application of immune checkpoint inhibitors (ICIs) represents a breakthrough in the current landscape for the treatment of extensive‐stage small‐cell lung cancer (ES‐SCLC), but the real‐world outcome is limited. This study aimed to investigate the treatment options and efficacy evaluation of first‐line, second‐line, and subsequent‐line immunotherapy in routine practice. Methods A retrospective analysis of ES‐SCLC patients treated with ICIs was conducted between May 2016 and September 2021. Objective response rate, disease control rate, progression‐free survival (PFS) and overall survival were assessed between groups to explore the value of ICIs at different treatment time periods. PFS1 and PFS2 were defined as the duration from initial therapy to disease progression or death in first‐line or second‐line treatment. Results Ninety‐six patients with ES‐SCLC were included. PFS1 was prolonged in patients treated with first‐line ICIs‐combined therapy (median PFS1 7.20 months vs. 5.30 months, hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.36–087, p = 0.0085). For patients who progressed after first‐line ICIs treatment (N = 22), PFS1 + PFS2 was longer in the second‐line ICIs continuation group with no significant difference (median PFS1 + PFS2 11.27 months vs. 7.20 months, HR 0.45, 95% CI 0.14–1.51, p = 0.19). For patients who experienced a progression event after first‐line chemotherapy (N = 50), PFS2 and PFS1 + PFS2 were prolonged in patients who accepted second‐line ICIs‐combined therapy without significant difference (median PFS2 4.00 months vs. 2.43 months, HR 0.59, 95% CI 0.33–1.05, p = 0.070; median PFS1 + PFS2 11.30 months vs. 8.70 months, HR 0.53, 95% CI 0.29–0.98, p = 0.056). Conclusion First‐line ICIs plus chemotherapy should be applied in the clinical practice of ES‐SCLC. If patients did not receive ICIs plus chemotherapy in first‐line treatment, therapies that include ICIs in second‐line treatment should be considered.

Purpose In the treatment of concurrent chemoradiotherapy (CCRT) in limited-stage small cell lung cancer, the optimal once-daily radiotherapy (RT) dose/fractionation remain unclear although it is the most frequently used. Therefore, this study aimed to compare the treatment outcomes and toxicities of modest dose RT (≤ 54 Gy) with those of standard dose RT (> 54 Gy) and investigate the benefit of the high dose based on patient factors. Materials and Methods Since 2004, our institution has gradually increased the thoracic RT dose. Among the 225 patients who underwent CCRT, 84 patients (37.3%) received > 54 Gy. Because the patients treated with RT > 54 Gy were not randomly assigned, propensity score matching (PSM) was performed. Results The proportion of patients treated with > 54 Gy increased over time (p=0.014). Multivariate analysis revealed that the overall tumor stage and dose > 54 Gy (hazard ratio, 0.65; p=0.029) were independent prognostic factors for overall survival (OS). PSM confirmed that thoracic RT doses of > 54 Gy showed significantly improved progression-free survival (3-year, 42.7% vs. 24.0%; p < 0.001) and OS (3-year, 56.2% vs. 38.5%; p=0.003). Sensitivity analysis also showed that 60 Gy resulted in better survival than 54 Gy. However, in patients with underlying lung disease, OS benefit from > 54 Gy was not observed but considerable rates of severe pulmonary toxicities were observed (p=0.001). Conclusion Our analysis supports that the 60 Gy RT dose should be considered in the once-daily regimen of CCRT for limited-stage small cell lung cancer without underlying lung disease, but RT dose > 54 Gy did not seem to benefit for patients with chronic obstructive pulmonary disease or interstitial lung disease. Further study is needed to validate these results. [ABSTRACT FROM AUTHOR]

Background: The application of immune checkpoint inhibitors (ICIs) represents a breakthrough in the current landscape for the treatment of extensive‐stage small‐cell lung cancer (ES‐SCLC), but the real‐world outcome is limited. This study aimed to investigate the treatment options and efficacy evaluation of first‐line, second‐line, and subsequent‐line immunotherapy in routine practice. Methods: A retrospective analysis of ES‐SCLC patients treated with ICIs was conducted between May 2016 and September 2021. Objective response rate, disease control rate, progression‐free survival (PFS) and overall survival were assessed between groups to explore the value of ICIs at different treatment time periods. PFS1 and PFS2 were defined as the duration from initial therapy to disease progression or death in first‐line or second‐line treatment. Results: Ninety‐six patients with ES‐SCLC were included. PFS1 was prolonged in patients treated with first‐line ICIs‐combined therapy (median PFS1 7.20 months vs. 5.30 months, hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.36–087, p = 0.0085). For patients who progressed after first‐line ICIs treatment (N = 22), PFS1 + PFS2 was longer in the second‐line ICIs continuation group with no significant difference (median PFS1 + PFS2 11.27 months vs. 7.20 months, HR 0.45, 95% CI 0.14–1.51, p = 0.19). For patients who experienced a progression event after first‐line chemotherapy (N = 50), PFS2 and PFS1 + PFS2 were prolonged in patients who accepted second‐line ICIs‐combined therapy without significant difference (median PFS2 4.00 months vs. 2.43 months, HR 0.59, 95% CI 0.33–1.05, p = 0.070; median PFS1 + PFS2 11.30 months vs. 8.70 months, HR 0.53, 95% CI 0.29–0.98, p = 0.056). Conclusion: First‐line ICIs plus chemotherapy should be applied in the clinical practice of ES‐SCLC. If patients did not receive ICIs plus chemotherapy in first‐line treatment, therapies that include ICIs in second‐line treatment should be considered. [ABSTRACT FROM AUTHOR]

Xiaochuan Zhang,1,2,&ast; Fajin Lv,1,&ast; Binjie Fu,1 Wangjia Li,1 Ruiyu Lin,1 Zhigang Chu1 1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Department of Radiology, Chonggang General Hospital, Chongqing, 400080, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhigang Chu, Tel +86 18723032809, Fax +86 23 68811487, Email chuzg0815@163.comPurpose: To investigate the clinical and computed tomography (CT) characteristics of peripheral small-cell lung cancer (pSCLC) to improve its early diagnosis.Patients and Methods: In total, 70, 132, 69, and 95 patients with pathological confirmed nodular (≤ 3 cm) pSCLC, peripheral non-small cell lung cancer (pNSCLC), benign lung tumor (pBLT), and inflammatory lesion (pIL) were enrolled in this study retrospectively. The clinical and CT data of studied patients with different lesions were analyzed and compared by univariate analysis. Multivariate analysis was used to reveal the key features to distinguish pSCLC from pNSCLC, pBLT, and pIL, respectively.Results: Univariate and multivariate analysis of the clinical and CT characteristics of studied patients indicated that 1) compared with pNSCLC and pIL, vessel convergence, spiculation, and peripheral ground-glass opacity were less common in pSCLC; 2) density homogeneity (OR = 38.84– 120.21, P < 0.05), bronchial cutoff sign (OR = 10.00– 60.13, P = 0.001), hilar lymph node enlargement (OR = 22.81– 95.08, P < 0.0001) (pSCLC vs pNSCLC, pBLT, and pIL), male sex (OR = 5.53– 10.92, P < 0.05) (pSCLC vs pNSCLC and pBLT), and emphysema (OR = 36.57– 56.63, P < 0.05) (pSCLC vs pBLT and pIL) were significantly and independently associated with pSCLC. Type I and II bronchial cutoff sign, especially type I, were closely related to pSCLC.Conclusion: Peripheral solid nodules with homogeneous density, bronchial cutoff sign, hilar lymph node enlargement, but without spiculation or vessel convergence in male patients with emphysema should be highly suspected of pSCLC.Keywords: small-cell lung carcinoma, non-small cell lung carcinoma, tomography, X-ray computed

An 86-year-old woman presented with chronic cough and chest pain. Computed tomography revealed two masses in the right lower lobe of the lung accompanied by multiple lymphadenopathies and metastasis to the rib. The pro-gastrin-releasing peptide (ProGRP) levels were notably elevated (888 pg/mL). Based on these findings, our initial clinical diagnosis was small-cell lung cancer. However, the pathological diagnosis turned out to be an atypical carcinoid. The patient was finally treated with everolimus. Clinicians should be aware that carcinoid tumours are sometimes difficult to distinguish from small-cell lung cancer with respect to high ProGRP levels and multiple metastases.

Small-cell lung carcinoma is a high-grade aggressive disease that occurs most commonly in bronchial lung cancer, and metastasis to the heart is extremely rare. The diagnosis of metastatic small-cell lung carcinoma infiltrating the heart remains challenging because of the variability of its clinical presentation. Hereinafter, we reported a case of a 41-year-old man who suffered from small-cell lung cancer that invaded the pulmonary artery. The patient presented with chest tightness, dry cough, and deterioration in exercise tolerance and diagnosed at his imaging data, who had an uneventful recovery after surgical resection of the masses., (© 2024 Wiley Periodicals LLC.)

Anti-Hu is the most commonly associated antibody in paraneoplastic syndromes (PNS) - mainly secondary to small cell lung cancer (SCLC), breast cancer, thymoma, and lymphoma. This case is about a 65-year-old female patient presenting with slurred speech, headache, and loss of balance for one day. On examination, she was found to have downbeat and bilateral gaze-evoked nystagmus, dysarthria, and bilateral intention tremors. The rest of the neurological examination was unremarkable. Upon investigation, a CT scan showed a pre-sacral mass and a PET scan showed a lobulated soft tissue mesenteric mass at L5/S1, thought to possibly be a gastrointestinal stromal tumour, and mediastinal lymph nodes including right lower pre-tracheal, subcarinal and right hilar lymph nodes. Additionally, paraneoplastic antibody testing was positive for anti-Hu antibodies. She was given a five-day course of intravenous immunoglobulin without significant clinical improvement. The patient was discharged on a fast-track pathway and did not undergo chemotherapy, radiotherapy or surgical resection as the primary tumour could not be diagnosed.  Paraneoplastic antibodies are a family of autoantibodies occurring as a result of malignancy that act to recognize antigens in the brain, resulting in a variety of neurological manifestations. Despite well-known literature on this entity, PNS is notoriously difficult to diagnose and manage. The first step in the management of PNS is to treat the underlying malignancy. Beyond this, the other key component of PNS treatment is immune modulation which may involve immunosuppression with high-dose corticosteroids, IV immunoglobulins, plasma exchange or plasmapheresis. It is therefore important for PNS to be diagnosed early and to adopt a comprehensive multidisciplinary approach to improve the outcomes of those presenting with PNS., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sumaruth et al.)

[Display omitted] • p53 and Rb alterations are confirmed as predisposing to SCLC transformation in EGFR- LUAD. • Paired EGFR-LUAD/SCLC samples showed diverse clonal evolution patterns. • TERT amplification is an acquired event during EGFR-LUAD to SCLC transformation. Among the different mechanisms of acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) reported in EGFR -mutated lung adenocarcinoma (EGFR -LUAD) patients, histological transformation into small cell carcinoma (SCLC) occurs in 3–14% of resistant cases, regardless of the generation of EGFR-TKI. In recent studies, bi-allelic inactivation of TP53 and RB1 has been identified in a vast majority of transformed SCLCs. However, the molecular mechanisms driving this histologic transformation remain largely unknown, mainly due to the rarity of samples. Out of an initial cohort of 64 patients, tumor tissues of adequate quality and quantity for whole exome sequencing (WES) analysis were available for nine tumors for six patients: paired pre- and post-SCLC transformation samples for three Patients and post-SCLC transformation samples for three other patients. Mutational analyses showed concurrent TP53 mutations and Rb pathway alterations in five of the six patients analyzed, confirming their suggested role as predisposing genetic alterations to SCLC transformation. In addition, TERT amplification was detected in four of the six patients and found to be an event acquired during SCLC transformation. Clonal history evolution analyses from the paired LUAD/SCLC samples showed different evolution patterns. In two patients, a large proportion of mutations were present in the most recent common ancestor cell of the initial LUAD and the transformed SCLC clones, whereas in the third patient, few clonal mutations were common between the LUAD and SCLC samples and the ancestor clone that lead to SCLC was present at low frequency in the initial LUAD. Despite varied clinical presentations and clonal history evolution patterns, in addition to p53 and Rb pathways alterations, TERT amplification emerged as another common genetic mechanism of EGFR- LUAD to SCLC transformation in our cohort, and could represent a candidate therapeutic target in this subset of SCLC tumors. [ABSTRACT FROM AUTHOR]

Lung carcinoma is a major cause of mortality worldwide. Small-cell lung cancer (SCLC) constitutes of about 10%–15% of cases of all lung cancer. It generally affects males more commonly than females and has smoking as a high-risk factor. It is generally a solid central tumor which spreads very rapidly to mediastinal lymph nodes and distant organs. It generally presents with mass effects such as cough, wheezing, superior vena cava syndrome and hemoptysis and also causes paraneoplastic syndrome. It is very rare for SCLC to present as isolated massive pleural effusion. Here in, we describe a case of massive pleural effusion which was diagnosed as small cell carcinoma with thoracoscopic pleural biopsy, and was managed with pleurodesis and cisplatin-based chemotherapy.

Abstract Background Small-cell lung cancer (SCLC) is a highly proliferative, rapidly growing tumor with a poor prognosis, even in cases of limited disease (LD). Timely and accurate high-intensity therapy is necessary. For concurrent chemoradiotherapy (CCRT), etoposide/platinum (EP)-based regimens are recommended, although irinotecan/platinum (IP)-based regimens are also effective with radiotherapy. This large-scale, retrospective, nationwide cohort study aimed to analyze the efficacy of CCRT in patients with LD-SCLC. Methods Population data registered between January 2008 and December 2018 was extracted from the Health Insurance Review and Assessment Service of Korea database. Survival outcomes of 4446 LD-SCLC patients who received CCRT were analyzed. Results Patients who received EP-CCRT (n = 4187) showed better time to first subsequent therapy (TFST: 11.2 months) and overall survival (OS: 22.2 months) than those who received IP-CCRT (n = 259; TFST: 9.6 months, P = 0.0477; OS: 16.4 months, P

Although precursor lesions of pulmonary squamous carcinoma, adenocarcinoma and carcinoid tumour are well known and accepted entities, precursor lesions of pulmonary neuroendocrine carcinomas, i.e. small‐cell lung carcinoma and large‐cell neuroendocrine carcinoma, have never been identified. A small body of literature documenting intraepithelial involvement in cases of pulmonary neuroendocrine carcinoma begs the question of whether the intraepithelial lesion represents de‐novo intraepithelial neoplasia or invasion by underlying tumour. In this article, the literature on cases of invasive neuroendocrine carcinomas with an intraepithelial component showing a neuroendocrine immunophenotype is thoroughly and critically reviewed. The authors of the publications of cases of coexisting invasive and intraepithelial neuroendocrine carcinoma generally favour invasion as the explanation for the intraepithelial component. However, in practice, it is difficult or impossible to determine the direction of migration of tumour cells when there is both an invasive component and an intraepithelial component. Pulmonary neuroendocrine carcinomas in situ have been produced in genetically engineered mouse models. On the basis of the illustrations in the literature of human cases and the production of pulmonary neuroendocrine carcinomas in situ in genetically engineered mice, it seems likely that these tumours also exist in humans. However, their existence and acceptance require definitive proof. Studies should be undertaken to identify bronchial and other lung biopsies with in‐situ carcinoma showing a neuroendocrine immunophenotype and a subsequent negative resection specimen and no follow‐up evidence of invasive carcinoma. Documenting such cases would provide definitive proof for the existence of pulmonary neuroendocrine carcinomas in situ in humans. [ABSTRACT FROM AUTHOR]

Tumor lysis syndrome (TLS) is an oncologic emergency. It generally occurs after chemotherapy but sometimes develops spontaneously in hematologic malignancy, such as leukemia. TLS is a rare phenomenon in patients with solid tumors, particularly when it develops spontaneously. Here, we present a case of spontaneous TLS (STLS) in a patient with small-cell lung cancer (SCLC). We report a case of STLS in a 59-year-old male patient who presented with dyspnea and oliguria. Clinicians should suspect TLS in patients with malignancy, who demonstrate the classic electrolyte abnormalities of TLS even if not receiving treatment such as chemotherapy or radiotherapy.

Background: Cold plasma is shown to inhibit the cancer cell growth. Manipulation of different plasma parameters might have influence on the production of major reactive species which leads to killing of the cancer cells. Antiproliferative activity of cold atmospheric pressure plasma jet was investigated on small-cell lung carcinoma BHY cell line (squamous cell carcinoma) under different in vitro conditions. Methods: A homemade plasma jet was designed and created using pure helium gas. To identify the species created by the plasma jet, optical emission spectroscopy (OES) was employed. Next, the effect of plasma jet was examined on lung cancer cell survival by MTT assay and the effects of main parameters were evaluated on plasma performance. In this favor, various treatment times including 60, 90, 120, 180, and 300 s in combination with different voltages of 5, 11, and 14 kV were investigated, and the results were analyzed at 2, 24, and 48 h after exposure to plasma. Results: Predominant species of OES spectra were O, OH, N2+, and N2. Results of MTT assay indicated a dramatic reduction in cell viabilities in both dose- and time-dependent manners, and more than 75% of cancer cells were died after 48 h at 180 s of plasma treatment. Conclusion: The homemade plasma jet can chiefly contribute to the production of reactive oxygen and nitrogen species (reactive oxygen species and reactive nitrogen species) and can induce apoptosis in small-cell lung carcinoma BHY cell line.

Gastrointestinal pseudo-obstruction (GIPO) is a phenotype of the paraneoplastic neurological syndrome (PNS). We herein report a case of small-cell lung carcinoma (SCLC) with GIPO elicited by an immune checkpoint inhibitor (ICI). A 75-year-old man with SCLC developed intractable intestinal obstruction after receiving one course of anticancer drugs (durvalumab, etoposide, and carboplatin). The serum anti-Hu antibody (Hu-Ab) was positive, and the patient was diagnosed with GIPO. Corticosteroid treatment did not improve the GIPO, and the patient died. There are few reports of GIPO after ICI treatment in patients with lung cancer, so a further investigation will be required to elucidate the mechanism by which ICIs elicit PNS. Checking for neuronal antibodies may help identify patients with SCLC who are at risk of developing PNS due to ICI treatment.

Small cell lung cancer (SCLC) is notorious for its aggressive behavior and propensity for metastasis. Although metastasis to the pancreas from SCLC is relatively rare, it warrants attention due to its overlapping symptomatology with primary pancreatic malignancies and other abdominal pathologies (such as those involving the liver or gallbladder). Despite recent advances, the mechanisms driving SCLC metastasis to the pancreas remain elusive, providing challenges in diagnosis and treatment. This case report details the presentation of a 59-year-old woman with SCLC metastasis to the pancreas, initially masquerading as primary pancreatic carcinoma, as highlighted by her presenting symptoms of jaundice, weight loss, and abdominal pain. Diagnostic workup, including imaging studies and tissue sampling, confirmed the unexpected presence of metastatic SCLC in the pancreas. The patient was ultimately transferred to a tertiary care facility for further workup. This case serves as a reminder to maintain a broad differential diagnosis, particularly in the face of such an unusual presentation. It also highlights the need for further research to elucidate the molecular and cellular mechanisms driving SCLC metastasis to the pancreas, with the ultimate goal of improving diagnostic accuracy and therapeutic outcomes for patients with this aggressive disease., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gampala et al.)

Superior vena cava (SVC) syndrome is an uncommon yet potentially fatal syndrome occurring after intrinsic or extrinsic compression to the SVC. While there are multiple emerging etiologies for this phenomenon, malignancy remains the most common. It is characterized by several symptoms including facial swelling, extremity swelling, shortness of breath, and headaches. We present the case of a 59-year-old female with a past medical history of cocaine abuse who was admitted for upper extremity swelling and facial edema. Imaging revealed a right suprahilar mass compressing a branch of the right pulmonary artery and SVC, in addition to bilateral segmental and subsegmental pulmonary emboli. She underwent an emergent biopsy and SVC stenting, with immunostaining revealing small cell lung cancer (SCLC). This case highlights a severe presentation of SVC syndrome caused by previously undetected SCLC., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Reddy et al.)

Paraneoplastic neurologic degeneration (PND) manifests as a sudden or subacute neurological syndrome often linked to underlying cancer, either overt or subclinical. Within the spectrum of PND, subacute paraneoplastic cerebellar degeneration (PCD) represents a distinctive subset. While rare, prompt diagnosis holds the potential to ameliorate both neurological and oncological outcomes. Herein, we present the case of a 61-year-old patient diagnosed with subacute cerebellar degeneration, ultimately unveiling non-small cell lung carcinoma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Kharouaa et al.)

Abstract Two male smokers developed small‐cell lung cancer (SCLC) as the second primary malignancy (SPM) in the irradiated field after concurrent chemoradiotherapy for locally advanced cancer, which could also be considered as a radiation‐induced tumour. A 70‐year‐old man received cisplatin and S‐1 and irradiation at 60 Gy for lung adenocarcinoma eight years previously and an 81‐year‐old man cisplatin and 5‐fluorouracil and at irradiation 60 Gy for oesophageal cancer five years previously. They sequentially received chemotherapy for SCLC, the effects of which were limited, and a refractory course was noted. Chemoradiotherapy is an effective treatment strategy for locally advanced cancer but may be relevant to the onset of SCLC as SPM.

Two male smokers developed small‐cell lung cancer (SCLC) as the second primary malignancy (SPM) in the irradiated field after concurrent chemoradiotherapy for locally advanced cancer, which could also be considered as a radiation‐induced tumour. A 70‐year‐old man received cisplatin and S‐1 and irradiation at 60 Gy for lung adenocarcinoma eight years previously and an 81‐year‐old man cisplatin and 5‐fluorouracil and at irradiation 60 Gy for oesophageal cancer five years previously. They sequentially received chemotherapy for SCLC, the effects of which were limited, and a refractory course was noted. Chemoradiotherapy is an effective treatment strategy for locally advanced cancer but may be relevant to the onset of SCLC as SPM. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the clinical outcomes of patients with different stages of small-cell lung cancer (SCLC) who underwent surgical treatment. MATERIAL AND METHODS: This retrospective study consisted of 13 patients with SCLC at a tertiary care health center. This study was conducted between 2011 and 2018 at Gaziantep University Faculty of Medicine, Thoracic Surgery Department. Patient follow-up data were collected from medical files. Patients were analyzed according to age, sex, site of resection, clinical stage, pathological stage, recurrence, operation type, chemotherapy, radiotherapy. RESULTS: The study group consisted of 3 females and 10 males (n = 13). The mean age of the patients was 65 ± 9.3 (52-85) years. The most common location of the primary tumor was the right upper lobe (6 patients, 46.2%). The mean tumor size was 4.36 ± 2.38 cm (1-8.5). In our study, 3 patients had already metastases (2 brain and 1 had metastases in more than 2 anatomic sites). Patients with solitary metastases, who underwent lung resection and metastasis excision had similar survival according to patients without metastases. CONCLUSION: Our results show that surgical treatment in SCLC could be contributed to the survival of patients. Therefore, patients must be given a chance for surgery, especially considering that the advances in diagnostic and surgical capabilities have increased the likelihood of early diagnosis and effective surgery. [ABSTRACT FROM AUTHOR]

Lung carcinoma is a major cause of mortality worldwide. Small-cell lung cancer (SCLC) constitutes of about 10%-15% of cases of all lung cancer. It generally affects males more commonly than females and has smoking as a high-risk factor. It is generally a solid central tumor which spreads very rapidly to mediastinal lymph nodes and distant organs. It generally presents with mass effects such as cough, wheezing, superior vena cava syndrome and hemoptysis and also causes paraneoplastic syndrome. It is very rare for SCLC to present as isolated massive pleural effusion. Here in, we describe a case of massive pleural effusion which was diagnosed as small cell carcinoma with thoracoscopic pleural biopsy, and was managed with pleurodesis and cisplatin-based chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Small-cell lung cancer (SCLC) is a highly proliferative, rapidly growing tumor with a poor prognosis, even in cases of limited disease (LD). Timely and accurate high-intensity therapy is necessary. For concurrent chemoradiotherapy (CCRT), etoposide/platinum (EP)-based regimens are recommended, although irinotecan/platinum (IP)-based regimens are also effective with radiotherapy. This large-scale, retrospective, nationwide cohort study aimed to analyze the efficacy of CCRT in patients with LD-SCLC.Methods: Population data registered between January 2008 and December 2018 was extracted from the Health Insurance Review and Assessment Service of Korea database. Survival outcomes of 4446 LD-SCLC patients who received CCRT were analyzed.Results: Patients who received EP-CCRT (n = 4187) showed better time to first subsequent therapy (TFST: 11.2 months) and overall survival (OS: 22.2 months) than those who received IP-CCRT (n = 259; TFST: 9.6 months, P = 0.0477; OS: 16.4 months, P <  0.0001). When CCRT failed, dual-agent chemotherapy (n = 925; OS: 9.1 months) provided a better survival benefit than single-agent chemotherapy (n = 815; OS: 7.5 months). IP-based chemotherapy resulted in better OS (9.6 months) than EP-based chemotherapy (7.1 months, P = 0.017) in platinum-resistant relapsed patients; the opposite was observed for platinum-sensitive relapsed patients (OS: EP, 17.2 months; IP, 6.6 months; P <  0.0001). Poisson regression analysis demonstrated that age, EP-CCRT, and hypercholesterolemia retained significant associations with OS after adjustment for all variables.Conclusion: In the Korean population, the effects of EP-CCRT on OS and TFST are significantly more favorable than those of IP-CCRT. [ABSTRACT FROM AUTHOR]

This is a case report of a 60-year-old diabetic, hypertensive male with a good performance status and a history of bilateral interstitial lung disease with a left upper lobe lung mass diagnosed to be a Stage IIB mixed small-cell/squamous cell carcinoma which was refractory to carboplatin- and etoposide-based chemotherapy. The patient was then taken up for adaptive intensity-modulated radiotherapy with tighter margin under image guidance with a mid-treatment replanning done at 25#. Acute toxicities were assessed weekly and showed no Grade 3 or more reactions. Pulmonary function test showed no detrimental changes during or after radiation. Response assessment at 12 and 20 weeks showed a partial response with decrease in metabolic activity on serial scans.

Objective: Lambert–Eaton myasthenic syndrome (LEMS) is a paraneoplastic neurological syndrome, most frequently associated with small‐cell lung carcinoma (SCLC). The survival of LEMS patients depends on the presence of SCLC, whereas the functional outcome in patients without SCLC has not been fully clarified. The aim of this study was to elucidate the long‐term prognosis of LEMS patients with or without SCLC. Methods: We collected data from seven consecutive Japanese patients with LEMS without SCLC (n = 4) or LEMS with SCLC (n = 3) consulting Chiba university hospital, Chiba, Japan from 2003 to 2019. The functional disability was assessed with the modified Rankin Scale. Results: The median observation period was 52 months (range 18–168 months); one LEMS with SCLC patient died as a result of SCLC 18 months after diagnosis, whereas the remaining two LEMS with SCLC patients with complete remission of their tumor still showed improvement in neurological symptoms 52 and 168 months after treatment, respectively. All LEMS patients without SCLC showed a favorable response to treatment and good functional prognosis (modified Rankin Scale 1 or 2) during the follow‐up period (48–120 months). Conclusions: In Japanese LEMS patients, the long‐term neurological outcome is generally favorable. Our results also suggest that even in LEMS with SCLC patients, successful treatment for their cancer could result in sustained improvement in neurological symptoms. [ABSTRACT FROM AUTHOR]

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Fundamental studies on biomarkers as well as developed assays for their detection can provide valuable information facilitating clinical decisions. For patients with lung cancer, there are established circulating biomarkers such as serum progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and cytokeratin-19 fragment (CYFRA21-1). There are also molecular biomarkers for targeted therapy such as epidermal growth factor receptor (EGFR) gene, anaplastic lymphoma kinase (ALK) gene, KRAS gene, and BRAF gene. However, there is still an unmet need for biomarkers that can be used for early detection and predict treatment response and survival. In this review, we describe the lung cancer biomarkers that are currently being used in clinical practice. We also discuss emerging preclinical and clinical studies on new biomarkers such as omics-based biomarkers for their potential clinical use to detect, predict, or monitor subtypes of lung cancer. Additionally, between-method differences in tumor markers warrant further development and improvement of the standardization and harmonization for each assay.

Small cell lung cancer (SCLC) is one of the deadliest forms of lung cancer, but few information exists regarding the role of genetics, particularly on Genome Wide Association Studies (GWAS). The aim of the study is to explore the evidence available obtained through GWAS studies for SCLC using a systematic review. We performed a literature search in the main databases until July 31st, 2023. We included all human based studies on GWAS for lung cancer which presented results for SCLC. Only studies with participants diagnosed of SCLC with anatomopathological confirmation were included. Fourteen studies were identified; 8 studies showed a relationship between ASCL1 overexpression and SCLC, which may regulate CHRNA5/A3/B4 cluster, producing a consequent nAChR overexpression. Nine papers, including 8 of the previous, found a positive association between SNPs located in chromosome 15 and SCLC. The most important cluster of genes found is CHRNA5/A3/B4 but the mechanism for the role of these genes is unclear. Kyoto Encyclopaedia of Genes and Genome (KEGG) shows that these receptors were found to be overexpressed where nicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N'-Nitrosonornicotine (NNN) acts, involving different routes in SCLC carcinogenesis., Competing Interests: Disclosure Karl Kelsey is a founder and scientific advisor to Cellintec, which had no role in this research. The other authors declare not to have any conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

We report a rare case of small-cell lung carcinoma with long-term survival treated in the Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. The pathological-clinical features and diagnosis-treatment progress were analyzed, and the comprehensive treatment strategies, tumor heterogeneity and prognosis of this tumor type were discussed by comparing with other previous studies. The 62-year-old patient was diagnosed with small-cell lung carcinoma and received surgery, radiotherapy and multi-line treatment, and had survived for 13 years after the surgery. The heterogeneity of small cell lung carcinoma should be carefully evaluated to improve the prognosis of the patients.

Background Small cell oesophageal carcinoma (SCEC), a rare neuroendocrine malignancy, presents various challenges in diagnosis and treatment. The condition is characterised by rapid dissemination, a marked responsiveness to chemotherapy, and a guarded prognosis. While the European Neuroendocrine Tumour Society has recommended platinum-based chemotherapy, ongoing debates on optimal strategies and the lack of clear guidelines underscore the need for further comprehensive research efforts. Methods This study retrospectively analysed 12 cases of localised pure SCEC treated at a UK tertiary care centre between 2006 and 2020. We systematically analysed and categorised the cases based on stage, performance status, and patient age. This comprehensive approach enabled a nuanced examination of overall survival (OS), thereby providing valuable insights into the differences between outcomes. Results The study revealed a median OS of 12.01 months for treated non-metastatic cases, highlighting the challenges of SCEC management. Conversely, treated metastatic cases exhibited a mean survival of 9.15 months, which contrasts starkly with the 2.55 months demonstrated by those receiving best supportive care (BSC). These figures underscore the urgency for refined strategies in handling advanced localised disease and the need to continue research endeavours to devise methods to enhance the precision and optimise outcomes beyond the presented data. Conclusion Based on our findings, the combination of chemoradiotherapy and surgery to manage SCEC holds promise; however, further research is needed to optimise the management approach. The lack of clear guidelines underscores the imperative for personalised treatment approaches., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Zemerly et al.)

Lung cancer, including small-cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC), are the most common tumor types, which represent 13% of newly diagnosed cancer cases worldwide. SCLC represents 15% of all lung cancer cases. Although an increasing number of novel targeted drugs are employed for the treatment of NSCLC, including Iressa, Tarceva and Conmana, there have been almost no major breakthroughs in SCLC over the last 30 years. Therefore, new drug targets are required to treat or prevent SCLC. Aberrant Wnt signaling is associated with numerous types of tumors, and it plays a key role in cell proliferation and survival. Recent preclinical studies suggested that XAV939 is a small-molecule inhibitor of the Wnt signaling pathway. In the present study, whether XAV939 is able to inhibit the proliferation of SCLC cells and the underlying mechanism were investigated. The inhibition of cell proliferation was detected by Cell Counting Kit-8 (CCK-8) assay. The mRNA expression of β-catenin and cyclin D1 were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and the protein expression of β-catenin and cyclin D1 was determined by western blotting. The results from the CCK-8 cell viability assay confirmed that XAV939 is able to inhibit the proliferation of SCLC cells in a dose-dependent manner. However, the effects of XAV939 were not time-dependent. By contrast, the effect of DDP treatment was time- and dose-dependent. Furthermore, the effect of combination treatment with XAV939 and DDP was antagonistic at low doses and synergistic at high doses. It was also observed that the mRNA and protein expression of β-catenin and cyclin D1 was significantly in SCLC cells following XAV939 treatment compared with the control group. These findings suggested that XAV939 is able to inhibit the proliferation of H446 cells, at least partially, through downregulating the Wnt/β-catenin signaling pathway. All of these results may provide potential therapeutic approaches for the treatment of SCLC. [ABSTRACT FROM AUTHOR]

Introduction: Neuronal calcium channel antibodies are a biomarker of Lambert-Eaton syndrome (LES) and cerebellar ataxia. We have encountered several patients with LES and cerebellar ataxia coexisting, and we sought to further define this association.Methods: We reviewed records of patients at our institution with a diagnosis of "Lambert-Eaton syndrome" and "cerebellar ataxia."Results: Seventeen patients were identified with LES and ataxia. Presenting symptoms were weakness (8), concurrent weakness and ataxia (4), ataxia (4), and other (1). Nine patients had small-cell lung carcinoma, 3 of whom had survival greater than 100 months. Immunotherapy responses were best among patients without cancer. Nine of 17 (53%) patients were alive at last follow-up (median survival 62 months; range, 8-240).Discussion: Calcium channel autoimmunity should be considered in patients with coexisting cerebellar ataxia and myasthenic weakness. Affected patients may survive small-cell carcinoma or have immunotherapy-responsive neurological symptoms. Muscle Nerve, 2018. [ABSTRACT FROM AUTHOR]

This is a case report of a 60-year-old diabetic, hypertensive male with a good performance status and a history of bilateral interstitial lung disease with a left upper lobe lung mass diagnosed to be a Stage IIB mixed small-cell/squamous cell carcinoma which was refractory to carboplatin- and etoposide-based chemotherapy. The patient was then taken up for adaptive intensity-modulated radiotherapy with tighter margin under image guidance with a mid-treatment replanning done at 25#. Acute toxicities were assessed weekly and showed no Grade 3 or more reactions. Pulmonary function test showed no detrimental changes during or after radiation. Response assessment at 12 and 20 weeks showed a partial response with decrease in metabolic activity on serial scans. [ABSTRACT FROM AUTHOR]

Synchronous multiple endocrine gland metastasis caused by small cell lung cancer (SCLC) is rare. A patient was investigated for primary cancer because of suspected brain metastasis on computed tomography (CT). Baseline 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT was positive in the lung and multiple endocrine glands (right thyroid, right breast, pancreatic body, right adrenal gland, and left ovary). Histopathology confirmed small cell lung cancer. The patient's symptoms were alleviated after chemotherapy and brain radiotherapy. Follow-up PET-CT revealed that some of the lesions had disappeared and some had reduced in size. This rare case of multiple endocrine gland metastases from SCLC suggests that whole body PET-CT is a useful tool to detect rare/asymptomatic metastases. [ABSTRACT FROM AUTHOR]