Molecular strategies in the management of bronchopulmonary and thymic neuroendocrine neoplasms

Thoracic NETs [bronchopulmonary and thymic NETs (TNET)] share a common anatomic primary location but exhibit substantially different spectra of clinical behavior. Although initially considered to share similar embryological origins (foregut), there is a limited understanding of their specific neuroendocrine cells of origin which range from neuroendocrine “K” or Kulchitsky cells to Clara cells. Overall, the conglomeration of such lesions as thoracic NETs is an archaic viewpoint based upon anatomical contiguities rather than cellular and molecular delineation. The different tumors grouped under this colliquation comprise well-differentiated NETs (typical and atypical “carcinoids” and poorly differentiated tumors (small cell and large cell neuroendocrine cancers). Other neuroendocrine lesions that occur in the thoracic cavity include paragangliomas and pheochromocytomas of the sympathetic chain as well neuroendocrine metastases from the gastroenteropancreatic system