Small-cell lung cancer [Neurosurgery Wiki]

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====== Small-cell lung cancer ======

Small cell [[lung cancer]] is a [[neuroendocrine tumor]].

It is sometimes called "[[oat cell carcinoma]]" due to the flat cell shape and scanty cytoplasm.

see [[Small cell lung cancer intracranial metastases]].

Small cell [[lung cancer]] (SCLC) is a life-threatening disease, typically caused by cigarette smoking. It is almost exclusively seen in current or former smokers. SCLC represents approximately 13–18% of all [[lung cancer]]s with a varying incidence in different countries
((Wahbah M, Boroumand N, Castro C, El-Zeky F, Eltorky M. Changing trends in the distribution of the histologic types of lung cancer: a review of 4,439 cases. Ann Diagn Pathol. 2007;11:89–96.))



====Epidemiology====
95 % arise in proximal airways, usually in mainstem or lobar brochii. Tipically younger (27-66 years) than other lung cancer. Strongly associated with cigarrete [[smoking]]

Although SCLC  compromises only 20 % of primary lung cancers, it is more likely to produce [[cerebral metastases]] than other brochogenic cell types (brain metastases are found in 80 % of patients who survive 2 yrs after diagnosis SCLC)
((Nugent JL, Bunn PA Jr, Matthews MJ, Ihde DC, Cohen MH, Gazdar A, Minna JD. CNS
metastases in small cell bronchogenic carcinoma: increasing frequency and
changing pattern with lengthening survival. Cancer. 1979 Nov;44(5):1885-93.
PubMed PMID: 227582.)).




====Classification====
A recommendation to use TNM International Union Against Cancer (UICC) staging system for all SCLC cases was regularly accepted
((UICC International Union Against Cancer . Lung. In: Sobin LH, Gospodarowicz MK, Wittekind Ch, editors. TNM classification of malignant tumours. 7th edition. Chichester: Wiley-Blackwell; 2009. pp. 138–46.))
((Debevec L, Jerič T, Kovač V, Sok M, Bitenc M. The progress in routine management of lung cancer patients. A comparative analysis of an institution in 1996 and 2006. Radiol Oncol. 2009;43:47–53.))
((Vallières E, Shepherd FA, Crowley J, Van Houtte P, Postmus PE, Carney D, et al. International Association for the Study of Lung Cancer International Staging Committee and Participating Institutions The IASLC Lung Cancer Staging Project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4:1049–59.)).

However, a simple two-stage system developed by the Veteran’s Administration Lung Cancer Study Group as limited (stage) disease (LD) or extensive (stage) disease (ED) was more frequently used in clinical practice
((Micke P, Faldum A, Metz T, Beeha K, Bittingerc F, Hengstlerd J, et al. Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer - what limits limited disease? Lung Cancer. 2002;37:271–6.)).

Patients with limited disease have the involvement restricted to one hemithorax that can be encompassed within a tolerable radiation field. Extensive disease is defined as disease beyond one hemithorax and may include malignant pleural or pericardial effusion or haematogenous metastases.

==== Diagnosis ====

Some tumors: most tumors are dark on [[DWI]], but highly cellular tumors may have decreased [[diffusion]] (bright on DWI) (e.g., [[epidermoid]]s, [[lymphoma]], some [[meningioma]]s, small cell [[lung cancer]]…). [[Restricted diffusion]] with tumors is usually not as bright as with [[stroke]] or [[abscess]]

==== Treatment ====
see [[Small cell lung cancer treatment]].


====Outcome====

see [[Small cell lung cancer outcome]].