• Nicholas Candy, Adam Young, Kieren Allinson, Oliver Carr, Jason McMillen, and Rikin Trivedi.
• Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
• World Neurosurg. 2017 Aug 1; 104: 1047.e1-1047.e6.

BackgroundMetastatic neuroendocrine carcinoma of unknown origin is a rare condition, usually presenting with lesions in the liver and/or lung. We present the first reported case of a metastatic neuroendocrine carcinoma of unknown origin arising in the femoral nerve sheath.Case DescriptionMagnetic resonance imaging demonstrated what was thought to be a schwannoma in the left femoral nerve sheath in the proximal femoral triangle, immediately inferior to the anterior inferior iliac spine. At the time of operation, the tumor capsule was invading surrounding tissue, as well as three trunks of the femoral nerve. The patient underwent a subtotal resection, preserving the integrity of the residual functioning femoral nerve trunks. Histologic evaluation determined that the tumor had features consistent with a metastatic neuroendocrine carcinoma of unknown primary origin. The patient recovered well postoperatively, and subsequent radiologic evaluation failed to demonstrate a potential primary site. Unfortunately, the patient re-presented with disease progression and was subsequently referred to palliative care.ConclusionsWe recommend that there is a definite role for surgery in the management of solitary neuroendocrine carcinoma of unknown origin.Copyright © 2017 Elsevier Inc. All rights reserved.

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