Small cell carcinoma has extremely poor prognosis. In the presence of metastases, the 2-yr survival rate is only 10%. In the absence of distant metastases, the 5-yr survival rate is about 25%. The median overall survival time is about 13 months after diagnosis. There is no survival difference between small cell carcinoma and large cell neuroendocrine carcinoma of lung. Favorable prognostic factors include: female sex, younger age, and surgically-resectable limited lesions. Adverse prognostic factors include: multiple metastatic sites (especially with CNS and/or bone marrow involvement), elevated LDH levels, low hemoglobin, continued smoking, and the presence of paraneoplastic syndromes. The image shows vascular invasion which is a frequent finding in small cell carcinoma of the lung.