Clinical Presentation: The average age at presentation is around 49 years with a strong male predilection. The presenting symptoms include chest pain, cough, dyspnea, and superior vena cava syndrome. Paraneoplastic manifestations include Cushing syndrome (common especially in pediatric cases), hypercalcemia/hypophosphatemia, acromegaly (rare) and syndrome of inappropriate ADH secretion (rare). Carcinoid syndrome is rarely seen. The image shows a uniform population of tumor cells forming rosettes and glandular spaces separated by a delicate fibrovascular stroma.