Bronchopulmonary neuroendocrine tumors account for only 20% of all lung carcinomas. These tumors are separated into four subtypes of low-grade (typical carcinoids), intermediate-grade (atypical carcinoids) and high-grade carcinomas which include large cell neuroendocrine carcinoma (LCNEC) and small-cell lung carcinoma (SCLC). LCNEC is a rare entity of aggressive cancer with poor prognosis. LCNEC is typically seen in older male with significant smoking history. We are presenting a young man with only five pack year smoking history and cushingoid features who was found to have LCNEC.