Nagihan KOLKIRAN, Ferhat EKİNCİ, Atike Pınar ERDOĞAN, Cihan GÖKTAN, Gamze GÖKSEL, Ahmet DİRİCAN

Vena Kava Süperior Sendromuyla Tanı Alan Yüksek Dereceli Nöroendokrin Karsinom: Olgu Sunumu

Nöroendokrin tümör, nöroendokrin hücrelerden köken alan nadir tümörlerdir. Bu tümörler köken aldıkları organın özelliklerini taşımalarına rağmen hepsi ortak nöroendokrin yapı gösterir. Akciğerin nöroendokrin tümörlerinde, tümörün yeri ve agresifliği klinik özelliklerini belirler. Merkezi yerleşimli nöroendokrin tümörlerde tekrarlayan enfeksiyonlar, göğüs ağrısı, öksürük, nefes darlığı, pnömöni ve vena kava superior sendromu gelişebilirken; periferik yerleşimli olanlar genellikle insidental olarak saptanır. Bu makalede, akciğer nöroendokrin tümör nedeniyle vena kava süperior sendromu gelişen olgunun tanısal süreci ve prognozu sunulmuştur. 59 yaş kadın hasta tarafımıza üç haftadır olan kolda şişlik ve nefes darlığı şikayeti ile başvurdu. Yapılan görüntüleme tetkiklerinde mediastende konglomere lenfadenopati, sağ paratrakeal bölgede vena kava süperiora belirgin bası oluşturan ve vena kava içerisine uzanan lenfadenopati saptanması üzerine vena kava süperior sendromu ön tanısı ile interne edildi. Hastaya steroid ve diüretik tedavisi başlandı. Yapılan biyopside yüksek dereceli nöroendokrin tümör saptanması üzerine karboplatin-etoposid kemoterapisi ve radyoterapi uygulandı. Tedavi altında görüntüleme tetkiki sonuçlarında belirgin regresyon saptanan hasta tedavisinin 2.ayında pulmoner emboli nedeniyle kaybedildi.

High Grade Neuroendocrine Carcinoma Diagnosed by Superior Vena Cava Syndrome: Case Report

Neuroendocrine tumor is a rare tumor originating from neuroendocrine cells. Although these tumors have the characteristics of the organ they originate from, they all show a common neuroendocrine structure. In neuroendocrine tumors of the lung, the location and aggressiveness of the tumor determine its clinical features. While recurrent infections, chest pain, cough, shortness of breath, pneumonia, and superior vena cava syndrome may develop in centrally located neuroendocrine tumors; peripherally located ones are usually detected incidentally. In this article, the diagnostic process and prognosis of the patient who developed vena cava superior syndrome due to lung neuroendocrine tumor is presented. A 59-year-old woman presented to us with complaints of swelling in the arm and shortness of breath for three weeks. In imaging examinations, conglomerate lymphadenopathy in the mediastinum, and lymphadenopathy that marked the vena cava superior in the right paratracheal region and extending into the vena cava were shown. Therefore, the patient was hospitalized with a preliminary diagnosis of vena cava superior syndrome. She was administered steroid and diuretic therapy. The biopsy shows high grade neuroendocrine tumor. Then, carboplatin-etoposide chemotherapy and radiotherapy were administered. The patient, who underwent significant regression in the imaging examination results, was exitus due to pulmonary embolism in the second month of treatment.

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