Understanding Neuroendocrine Carcinomas: Definitions, Types, and Clinical Presentation

Welcome back to another AJMC Peer Exchange series. In this episode titled, 'Understanding Neuroendocrine Carcinomas: Definitions, Types, and Clinical Presentation,' Ryan Haumschild led the conversation about the following questions:

What is the definition of neuroendocrine carcinoma, what are the different types, i.e. small-cell lung cancer vs. extrapulmonary, and how do they present clinically?

How are neuroendocrine carcinomas different from neuroendocrine tumors?

Ryan Haumschild, William Oh, Aman Chauhan, Namrata Vijayvergia, and Sandy Kotiah discussed the classification of neuroendocrine neoplasms, distinguishing between poorly differentiated neuroendocrine carcinomas (NECs) and well-differentiated neuroendocrine tumors (NETs) based on World Health Organization (WHO) guidelines updated in 2017 and 2019. The panelists highlighted key features of NECs, including high proliferation indices, aggressive behavior, and poor survival outcomes, while noting that small cell morphology tends to present more aggressively than large cell morphology. They also explored how NETs, even at higher grades, maintain cellular differentiation and demonstrate better outcomes than NECs, though they respond less favorably to chemotherapy. The discussion underscored the significant unmet need in treatment options for patients with extrapulmonary neuroendocrine carcinoma (epNEC).

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'The Diagnostic Journey in Extrapulmonary Neuroendocrine Carcinoma: Team-Based Care and Classification,' panelists continue their discussion on extrapulmonary neuroendocrine carcinoma and highlight the multidisciplinary specialties involved in diagnosis and care coordination, the patient experience navigating an epNEC diagnosis, and how pathologists characterize and classify extrapulmonary neuroendocrine carcinomas.