Giant mediastinal neuroendocrine tumor successfully resected after transarterial chemoembolization of drug-eluting embolic microspheres: A case report

RATIONALE: Neuroendocrine tumors (NETs) in the mediastinum are extremely rare. No uniform solution currently exists for the treatment of mediastinal NETs. PATIENT CONCERNS: We report the case of a 32-year-old man with symptoms of chest tightness, chest pain, cough, and panic. DIAGNOSES: Computed tomography showed that the mediastinum and right lung occupied a space with uneven enhancement. A needle biopsy revealed mediastinal NETs. An atypical carcinoid was diagnosed using immunohistochemistry. INTERVENTIONS: The patient underwent 2 similar transarterial chemoembolizations of drug-eluting embolic microsphere procedures after 5 cycles of etoposide and cisplatin chemotherapy. The patient underwent successful surgical resection 2 months after the operation. OUTCOMES: The patient's quality of life was significantly improved, without chest tightness, chest pain, or other symptoms. At the 1-year follow-up, the patient had no tumor recurrence. LESSONS: For large mediastinal NETs with poor chemotherapy effects, surgical resection is safe and feasible after down-staging treatment via arterial chemoembolization of drug-eluting embolic microspheres.