Primary neuroendocrine neoplasms of the mediastinum are extremely rare. We report the case of a 54-year-old woman who presented with dyspnea and was found to have a 6.8-cm tumor completely obliterating the right main pulmonary artery. Analysis of an endobronchial ultrasound fine-needle aspiration revealed a neuroendocrine tumor. A positron emission tomography scan showed no evidence of distant disease. The patient underwent surgical resection with reconstruction of the right main pulmonary artery with a Dacron (DuPont, Wilmington, DE) graft, followed by chemoradiotherapy. We discuss the presentation and management of this patient and review the current treatment options of primary neuroendocrine carcinomas of the mediastinum.

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