Urgent Chemotherapy for Aggressive Metastatic Neuroendocrine Cancer With Impending Hepatic Failure: A Case Report

Neuroendocrine carcinoma is a rare, biologically diverse malignancy that frequently presents with metastatic disease, which can carry a poor prognosis. Its symptomatology is often nonspecific, resulting in delayed diagnosis with substantial tumor burden. Platinum-based chemotherapy remains the cornerstone of treatment, although outcomes remain poor and novel therapeutic strategies are needed. We report a case of newly diagnosed metastatic neuroendocrine cancer in a patient presenting with vague constitutional and gastrointestinal symptoms, ultimately complicated by impending hepatic failure from extensive liver involvement. Initial evaluation raised greater concern for lymphoma or thyroid malignancy, given the pattern of lymphadenopathy and imaging findings. However, tissue biopsy ultimately revealed metastatic neuroendocrine carcinoma. This case underscores the aggressive nature of the poorly differentiated neuroendocrine carcinoma subtype, the importance of early recognition, and the challenges of managing patients with rapidly progressive disease.