LCNEC of Nasal Cavity: Diagnostic and Treatment Modalities—Case Report and a Narrative Review

Abstract

Large cell neuroendocrine carcinoma (LCNEC) of the nasal cavity is a rare epithelial malignancy with only a few cases reported to date. In this article, we present a case report of a 48-year-old male, who presented with a history of epistaxis and nasal blockage for over 1 year and was initially diagnosed as undifferentiated carcinoma further confirmed as LCNEC by histological findings and immunohistochemistry. The patient was managed by neoadjuvant chemotherapy followed by concurrent chemoradiotherapy. After follow-up for 18 months, the patient continues to be in complete clinical, histopathological, and radiological remission. The following report also discusses the rarity, presentation, and various treatment modalities and their outcomes as per current knowledge. Essentially, through this article, we want to highlight the crucial role of the degree of differentiation in such malignancies, the outcome of different treatment modalities used till now, and how these aspects play a crucial role in the treatment and prognosis of such carcinomas.

Keywords

concurrent chemoradiotherapy - large cell neuroendocrine carcinoma - nasal cavity

Patient Consent

Patient consent has been taken.

Affiliation where the work was carried out: AFMC & CH (SC), Pune.

Publication History

Article published online:
07 November 2025

• References

• 1 Corbett V, Arnold S, Anthony L, Chauhan A. Management of large cell neuroendocrine carcinoma. 2021; 11: 1-20
• 2 Seiwert TY, Salama JK, Vokes EE. The concurrent chemoradiation paradigm--general principles. Nat Clin Pract Oncol 2007; 4 (02) 86-100
• 3 Lahma J, Hejjouji R, Gicquel P, Essakalli L. Large cell neuroendocrine carcinoma of the nasal cavity: an extremely rare and new distinct entity. Pan Afr Med J 2018; 30: 188
• 4 Wu W, Gan P, Xu Q, Wang Y, Liao H. Neuroendocrine carcinoma of the nasal cavity with epiphora as the first symptom: a case report. Medicine (Baltimore) 2020; 99 (49) e23502
• 5 Thompson ED, Stelow EB, Mills SE, Westra WH, Bishop JA. Large cell neuroendocrine carcinoma of the head and neck: a clinicopathologic series of 10 cases with an emphasis on HPV status. Am J Surg Pathol 2016; 40 (04) 471-478
• 6 Mills SE. Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas. Mod Pathol 2002; 15 (03) 264-278
• 7 Survival O. Head and neck large cell neuroendocrine carcinoma should be separated from atypical carcinoid on the basis of different clinical features. 2012; 36 (02) 185-192
• 8 Shah K, Perez-Ordóñez B. Neuroendocrine neoplasms of the sinonasal tract: neuroendocrine carcinomas and olfactory neuroblastoma. Head Neck Pathol 2016; 10 (01) 85-94
• 9 Ferlito A, Strojan P, Lewis Jr JS, Perez-Ordoñez B, Rinaldo A. Large cell neuroendocrine carcinoma of the head and neck: a distinct clinicopathologic entity. Eur Arch Otorhinolaryngol 2014; 271 (08) 2093-2095
• 10 van der Laan TP, Iepsma R, Witjes MJH, van der Laan BFAM, Plaat BEC, Halmos GB. Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma: the importance of differentiation grade in determining treatment strategy. Oral Oncol 2016; 63: 1-9
• 11 Bell D, Hanna EY, Weber RS. et al. Neuroendocrine neoplasms of the sinonasal region. Head Neck 2016; 38 (Suppl. 01) E2259-E2266
• 12 De Ruysscher D, Botterweck A, Dirx M. et al. Eligibility for concurrent chemotherapy and radiotherapy of locally advanced lung cancer patients: a prospective, population-based study. Ann Oncol 2009; 20 (01) 98-102
• 13 Tang LL, Guo R, Zhang N. et al. Effect of radiotherapy alone vs radiotherapy with concurrent chemoradiotherapy on survival without disease relapse in patients with low-risk nasopharyngeal carcinoma: a randomized clinical trial. JAMA 2022; 328 (08) 728-736
• 14 Zhao Q, Wei J, Zhang C. et al. Large-cell neuroendocrine carcinoma of nasal cavity and paranasal sinuses after successful curative therapy: a case report and literature review. OncoTargets Ther 2019; 12: 2975-2980
• 15 Wasserman JK, Papp S, Hope AJ, Perez-Ordóñez B. Epstein-Barr virus-positive large cell neuroendocrine carcinoma of the nasopharynx: report of a case with complete clinical and radiological response after combined chemoradiotherapy. Head Neck Pathol 2018; 12 (04) 587-591
• 16 Cai Z, Lin M, Blanco AI, Liu J, Zhu H. Epstein – Barr virus-positive large cell neuroendocrine carcinoma of the nasopharynx: report of one case and review of the literature. Head Neck Pathol 2019; 13 (03) 313-317