1
|
Strojan P, Hernandez-Prera JC, Beitler JJ, Eisbruch A, Saba NF, Mendenhall WM, Nieto CS, Smee R, Rinaldo A, Ferlito A. Small cell and large cell neuroendocrine carcinoma of the larynx: A comparative analysis. Cancer Treat Rev 2019; 78:42-51. [DOI: 10.1016/j.ctrv.2019.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
|
2
|
Wakasaki T, Yasumatsu R, Masuda M, Matsuo M, Tamae A, Kubo K, Kogo R, Uchi R, Taura M, Nakagawa T. Small Cell Carcinoma in the Head and Neck. Ann Otol Rhinol Laryngol 2019; 128:1006-1012. [PMID: 31161776 DOI: 10.1177/0003489419853601] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Small cell carcinomas in extrapulmonary sites (ESmCCs) are very rare. ESmCCs originating in the head and neck account for approximately 10% of all ESmCCs, and there are few reports about this disease. ESmCCs have an aggressive natural history characterized by widespread metastasis. The aim of this study was to investigate the characteristics and outcomes of patients with ESmCCs of the head and neck. METHODS The outcomes of 21 patients with ESmCCs of the head and neck treated between January 2001 and December 2015 at the authors' hospital and associated facilities were reviewed. RESULTS There were 18 men and 3 women, and the median age was 74 years (range, 53-91 years). The tumor site was the larynx in 6 patients; the paranasal sinus in 5; the hypopharynx in 3; the oropharynx in 2; the nasopharynx in 2; and the oral cavity, salivary gland, and primary unknown in 1 patient each. The extent of the disease was staged as follows: stage I or II, 3 cases; stage III, 4 cases; stage IVA, 9 cases; stage IVB, 1 case; and stage IVC, 4 cases. The median observation time was 17 months (range, 1-103 months). Four patients (19%) had distant metastasis at initial treatment, and 13 patients (62%) developed distant metastasis within 3 years. Treatments were administered, including radical surgery (9 patients), radiation therapy (5 patients), chemoradiotherapy (7 patients), and chemotherapy (6 patients). The 1- and 3-year overall survival rates of patients were 56% and 37%, respectively. More than half of the patients died of distant metastasis. CONCLUSIONS ESmCCs of the head and neck have a poor prognosis, similar to those of carcinomas in many other sites. Control of distant metastasis would contribute to improving the prognosis of ESmCCs of the head and neck. Further studies are required for better understanding these disease entities and their response to treatment modalities.
Collapse
Affiliation(s)
- Takahiro Wakasaki
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuji Yasumatsu
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Muneyuki Masuda
- Department of Head and Neck Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Mioko Matsuo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Head and Neck Surgery, Japan Community Health Care Organization, Kyushu Hospital, Kitakyushu, Japan
| | - Akihiro Tamae
- Department of Otorhinolaryngology, Hamanomachi Hospital, Fukuoka, Japan
| | - Kazuhiko Kubo
- Department of Otorhinolaryngology, Chidoribashi General Hospital, Fukuoka, Japan
| | - Ryunosuke Kogo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryutaro Uchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiko Taura
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
3
|
Procopio G, Ricotta R, Fusi A, Celio L, De Dosso S, Catena L, Ferrari L, Quattrone P, Verzoni E, Bajetta E. Neuroendocrine Tumors of the Larynx: A Clinical Report and Literature Review. TUMORI JOURNAL 2018. [DOI: 10.1177/030089160609200112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giuseppe Procopio
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Riccardo Ricotta
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Alberto Fusi
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Luigi Celio
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Sara De Dosso
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Laura Catena
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Leonardo Ferrari
- Nuclear Medicine Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Pasquale Quattrone
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Elena Verzoni
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| | - Emilio Bajetta
- Medical Oncology Unit 2, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
| |
Collapse
|
4
|
Pointer KB, Ko HC, Brower JV, Witek ME, Kimple RJ, Lloyd RV, Harari PM, Baschnagel AM. Small cell carcinoma of the head and neck: An analysis of the National Cancer Database. Oral Oncol 2017; 69:92-98. [PMID: 28559027 DOI: 10.1016/j.oraloncology.2017.04.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/08/2017] [Accepted: 04/12/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate treatment trends and overall survival of patients with small cell carcinoma of the head and neck region. MATERIALS/METHODS Patients from 2004 to 2012 were identified from the National Cancer Database. Patient demographics and overall survival were analyzed. Multivariable analysis was used to identify predictors of survival. RESULTS Among 347,252 head and neck patients a total of 1042 (0.3%) patients with small cell carcinoma were identified. 17% of patients were diagnosed as stage I/II, 61% as stage III/IVA/IVB and 22% as stage IVC disease. The distribution by anatomic site was 9% oral cavity, 12% oropharynx, 35% larynx, 4% hypopharynx, 10% nasopharynx and 30% nasal cavity and paranasal sinuses. The median overall survival by anatomical site was 20.8months for oral cavity, 23.7months for oropharynx, 17.9months for larynx/hypopharynx, 15.1months for nasopharynx and 36.4months for nasal cavity primary tumors. On multivariable analysis across stage, patients with nasal cavity and paranasal sinuses tumors had the best survival and patients with nasopharynx primaries had the worst survival. In stage I/II patients, type of treatment delivered resulted in no overall survival difference (p=0.78). In patients with locally advanced disease, there was no difference in survival between those treated with combined surgery, radiotherapy and chemotherapy compared to those treated only with radiotherapy and chemotherapy (p=0.46). The addition of radiotherapy to chemotherapy in the metastatic setting did not result in improved survival (p=0.14). CONCLUSIONS Small cell carcinoma of the head and neck is a rare malignancy with a poor prognosis. The addition of surgery to radiotherapy and chemotherapy did not improve survival in patients with locally advanced disease.
Collapse
Affiliation(s)
- Kelli B Pointer
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Huaising C Ko
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jeffrey V Brower
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Matthew E Witek
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Randall J Kimple
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ricardo V Lloyd
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Paul M Harari
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Andrew M Baschnagel
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| |
Collapse
|
5
|
Hanakawa H, Inokuchi I, Ayada N, Egusa K, Doumae S, Minagi M, Fukumasu I, Kono T, Miura N, Takada S, Orita Y, Nishizaki K. [Laryngeal Atypical Carcinoid Combined with Squamous Cell Carcinoma: A Case Report]. ACTA ACUST UNITED AC 2015; 118:34-9. [PMID: 26333270 DOI: 10.3950/jibiinkoka.118.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The primary laryngeal atypical carcinoid is relatively rare, and the tumor combined with other histologic types including squamous cell carcinoma is extremely rare. We experienced a case which was complicated with atypical carcinoid and squamous cell carcinoma. A 79 years old man complaining of sputum was admitted to Hiroshima City Hospital. A tumor was seen in over the right glottis and the right vocal fold was fixed. Squamous cell carcinoma was diagnosed based on a biopsy harvested under laryngoscopy. Imaging studies (CT, MRI) were done. The primary tumor was in the right aryepiglottic fold, and one swollen lymph node was found in level 2 (right side). Based on the findings, the stage was T3N1M0. We performed a total laryngectomy and right neck dissection. Atypical carcinoid and squamous cell carcinoma were detected in the same tumor. There were two lymph node metastases, both of which were atypical carcinoid metastases. Postoperative irradiation was provided. It is now 4 years since the operation, but the patient lives without relapse and metastasis of this disease.
Collapse
|
6
|
Görner M, Brasch F, Hirnle P, Gehl HB, Scholtz LU, Wegehenkel K, Sudhoff H. Multimodality treatment for poorly differentiated neuroendocrine head and neck carcinomas - a single institution experience. Eur J Cancer Care (Engl) 2013; 22:648-52. [DOI: 10.1111/ecc.12070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M. Görner
- Department for Hematology, Oncology and Palliative Care; Academic Teaching Hospital Bielefeld; Bielefeld
| | - F. Brasch
- Department for Pathology; Academic Teaching Hospital Bielefeld; Bielefeld
| | - P. Hirnle
- Department of Radiation Oncology; Academic Teaching Hospital Bielefeld; Bielefeld
| | - H.-B. Gehl
- Department of Radiology; Academic Teaching Hospital Bielefeld; Bielefeld
| | - L.-U. Scholtz
- Department of Otolaryngology, Head and Neck Surgery; Academic Teaching Hospital Bielefeld; Bielefeld
| | - K. Wegehenkel
- Department for Hematology, Oncology and Palliative Care; Academic Teaching Hospital Bielefeld; Bielefeld
| | - H. Sudhoff
- Department of Otolaryngology, Head and Neck Surgery; Academic Teaching Hospital Bielefeld; Bielefeld
| |
Collapse
|
7
|
Scaduto M, Matrka L, Shah M, Wakely P, Ozer E. Poorly differentiated small-cell neuroendocrine carcinoma of the submandibular gland: a case report. EAR, NOSE & THROAT JOURNAL 2012; 91:E10-3. [PMID: 22522359 DOI: 10.1177/014556131209100416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Neuroendocrine carcinoma (NEC) is uncommon in the head and neck and rare in the salivary glands. In the latter location, it may manifest as pain or a palpable mass. These tumors can be quite aggressive, with a tendency toward recurrence and regional and distant metastasis. Because of the limited number of reported cases in the literature, no reliable treatment has been established. We describe the case of a 79-year-old man who presented with a persistent submandibular mass that was suspicious for a malignancy on imaging. Following surgical resection and histopathologic analysis, a diagnosis of poorly differentiated small-cell NEC was made. The patient was further treated with postoperative chemotherapy, and he exhibited no evidence of recurrence or metastasis on follow-up.
Collapse
Affiliation(s)
- Mary Scaduto
- Department of Otolaryngology, Cardinal Glennon Children's Medical Center, St. Louis, MO, USA
| | | | | | | | | |
Collapse
|
8
|
Oberstein PE, Kenney B, Krishnamoorthy SK, Woo Y, Saif MW. Metastatic gastric large cell neuroendocrine carcinoma: a case report and review of literature. Clin Colorectal Cancer 2012; 11:218-23. [PMID: 22421002 DOI: 10.1016/j.clcc.2012.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 12/16/2011] [Accepted: 01/20/2012] [Indexed: 02/08/2023]
Affiliation(s)
- Paul E Oberstein
- Columbia University, College of Physicians and Surgeons at New York-Presbyterian Hospital, New York, NY 10032, USA
| | | | | | | | | |
Collapse
|
9
|
Hatoum GF, Patton B, Takita C, Abdel-Wahab M, LaFave K, Weed D, Reis IM. Small Cell Carcinoma of the Head and Neck: The University of Miami Experience. Int J Radiat Oncol Biol Phys 2009; 74:477-81. [DOI: 10.1016/j.ijrobp.2008.08.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Revised: 07/25/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
|
10
|
Iso Y, Tagaya N, Nemoto T, Kita J, Sawada T, Kubota K. Incarceration of a large cell neuroendocrine carcinoma arising from the proximal stomach with an organoaxial gastric volvulus through an esophageal hiatal hernia: report of a case. Surg Today 2009; 39:148-52. [PMID: 19198995 DOI: 10.1007/s00595-008-3804-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2008] [Accepted: 04/06/2008] [Indexed: 10/21/2022]
Abstract
An 86-year-old woman was admitted to the hospital to undergo an examination for tarry stools. Laboratory tests showed hypoproteinemia and renal dysfunction. Upper gastrointestinal endoscopy demonstrated a type 5 tumor located in the upper body of the stomach. An upper gastrointestinal series and computed tomography revealed an organoaxial gastric volvulus and the dislocation of the proximal stomach through an esophageal hiatal hernia. The preoperative diagnosis was the incarceration of a gastric carcinoma arising from the proximal stomach with an organoaxial gastric volvulus through an esophageal hiatal hernia. A total gastrectomy and hernia repair were performed. A microscopic examination of the surgical specimen revealed a gastric large cell neuroendocrine carcinoma (GLCNEC). The patient was discharged 22 days after the surgery. Although the prognosis of GLCNEC is significantly worse than that of a conventional adenocarcinoma, the patient was doing well without recurrence at 15 months after surgery. The details of this case are reported with some bibliographical comments.
Collapse
Affiliation(s)
- Yukihiro Iso
- Second Department of Surgery, Dokkyo Medical University, 880 Mibu, Tochigi, 321-0293, Japan
| | | | | | | | | | | |
Collapse
|
11
|
Abstract
Small cell carcinoma (SCC) has become recognized as a distinct, though relatively infrequent, clinical pathology that occurs in multiple sites throughout the head and neck. Excluding cases that are considered to arise from skin, SCC in the head and neck has been found to develop in nearly all structures associated with the upper aerodigestive tract. Among the head and neck sites, the frequency of SCC is greatest in the larynx, with salivary glands and the sinonasal region comprising the other principle areas of origin. Controversy exist as to whether SCC can develop as a distinct entity in the thyroid, with most tumors that previously would have been considered as SCC now found to be lymphomas or variant forms of other types of thyroid malignancy. While there seems to be some differences among tumors arising from the various subsites, in general all SCC that originate in the head and neck have a tendency for aggressive local invasion and a strong propensity for both regional and distant metastasis. Treatment may include surgical resection, radiotherapy, chemotherapy, or some combination of these modalities. Due to the infrequency of these tumors, it is very unlikely that any large, controlled study will ever be done. For this reason, recommendations for treatment of SCC arising in the head and neck are based primarily on retrospective data from various small case series and on comparative data for treatment of SCC of bronchogenic and other extrapulmonary origin. Although patients with truly limited local disease may enjoy some prolonged survival, most patients with this tumor do poorly despite all current attempts at treatment.
Collapse
Affiliation(s)
- Gregory Renner
- Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA.
| |
Collapse
|
12
|
Huang SS, Jan YJ, Cheng SB, Yeh DC, Wu CC, Liu TJ, P'eng FK. Large Cell Neuroendocrine Carcinoma of the Ampulla of Vater: Report of a Case. Surg Today 2006; 36:1032-5. [PMID: 17072731 DOI: 10.1007/s00595-006-3285-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 05/16/2006] [Indexed: 12/13/2022]
Abstract
Large cell neuroendocrine carcinoma in the ampulla of Vater is rare and very different from the common ampullary adenocarcinoma. A 59-year-old man was admitted with obstructive jaundice. Gastroendoscopy showed a swollen ampulla of Vater and pathological examination of an ampullary biopsy revealed findings of a carcinoid tumor. After endoscopic biliary drainage, he underwent pancreaticoduodenectomy. A diagnosis of large cell neuroendocrine carcinoma was confirmed by immunohistochemical examination of the resected specimen. Despite adjuvant chemotherapy with cyclophosphamide and cisplatin, liver and peritoneal metastasis developed within 5 months and he survived for only 10 months after the operation. Thus, further investigations are needed to find a more effective postoperative adjuvant chemotherapy agent to treat patients with this aggressive tumor.
Collapse
Affiliation(s)
- So-Sen Huang
- Department of Surgery, Taichung Veterans General Hospital, Section 3, 160 Chung-Kang Road, Taichung, Taiwan
| | | | | | | | | | | | | |
Collapse
|
13
|
Ferlito A, Devaney KO, Rinaldo A. Neuroendocrine neoplasms of the larynx: Advances in identification, understanding, and management. Oral Oncol 2006; 42:770-88. [PMID: 16815077 DOI: 10.1016/j.oraloncology.2006.01.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 01/06/2006] [Indexed: 10/24/2022]
Abstract
While 85-90% of laryngeal malignancies prove to be squamous carcinomas, the second most common tumour type found in the laryngeal region will prove to be a member of the family of neuroendocrine tumours. Laryngeal carcinoid tumours have a capacity for metastasis, and so are more aggressive tumours than their light microscopic features might imply--5-year survival rates are in the vicinity of 50%. Laryngeal atypical carcinoid tumours are lesions with a well-recognized capacity for local recurrence as well as metastasis, with a 5-year survival of just under 50%. Laryngeal small cell neuroendocrine carcinomas are particularly aggressive tumours, with a 5-year survival of no more than 5-10%. Laryngeal paragangliomas are lesions without any real capacity for metastasizing. Surgical excision is the mainstay of treatment of carcinoid tumours, atypical carcinoid tumours, and paragangliomas. Small cell neuroendocrine carcinomas are chiefly treated by way of radiation and chemotherapy; the role of adjuvant therapy in the treatment of atypical carcinoid tumours remains to be established.
Collapse
Affiliation(s)
- Alfio Ferlito
- Department of Surgical Sciences, ENT Clinic, University of Udine, Policlinico Universitario, Piazzale S. Maria della Misericordia, I-33100 Udine, Italy.
| | | | | |
Collapse
|
14
|
Chung JH, Lee SS, Shim YS, Kim SY, Nam SY, Kim DH, Cho KJ. A Study of Moderately Differentiated Neuroendocrine Carcinomas of the Larynx and an Examination of Non-Neoplastic Larynx Tissue for Neuroendocrine Cells. Laryngoscope 2004; 114:1264-70. [PMID: 15235358 DOI: 10.1097/00005537-200407000-00023] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the most appropriate terminology for neuroendocrine carcinomas (NEC) of the larynx, successive clinicopathologic studies are encouraged. The typical location and immunophenotype of laryngeal NEC raise a question of whether any precursor cells exist. STUDY DESIGN Six patients with laryngeal NEC were analyzed. Another 20 laryngectomy specimens were examined for the presence of non-neoplastic neuroendocrine cells. METHODS Tumor morphology and patient outcome were determined, and tumor tissue underwent immunohistochemical examination to identify cytokeratin, neuroendocrine markers (chromogranin, synaptophysin, CD56, calcitonin), S-100 protein, and p53 protein. A neuroendocrine marker study was also performed on non-neoplastic regions of another 20 laryngectomy specimens to identify any neuroendocrine cells. RESULTS Laryngeal NEC, all submucosal, exhibited various morphology with or without histologic evidences of neuroendocrine differentiation. The tumors showed frequent (67%) calcitonin expression, calcitonin secretion in one case, and common (50%) p53 over-expression. Three patients died within 3 years. In the non-neoplastic larynx specimens, Kulchitsky cell-like bipolar neuroendocrine cells were identified in the basal and middle layer of the respiratory epithelium of the ventricle and subglottis but none in the submucosal layer of the supraglottic region. The neuroendocrine cells did not express calcitonin. CONCLUSIONS Moderately differentiated or large-cell NEC is a more favored term than atypical carcinoid until more refined classifications for upper respiratory tract NEC are agreed on. Despite the confirmed presence of neuroendocrine cells in the respiratory epithelium of the larynx, the origin of laryngeal NEC remains unknown. p53 mutation might be one of the major molecular steps in the pathogenesis of laryngeal NEC.
Collapse
Affiliation(s)
- Jin-Haeng Chung
- Department of Pathology, Korea Cancer Center Hospital, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
OBJECTIVES To review the clinical and pathological picture of laryngeal paragangliomas and compare laryngeal paragangliomas with the three other types of laryngeal neuroendocrine neoplasms. STUDY DESIGN The study presents a case review of a patient with a subglottic laryngeal paraganglioma treated at our institution, with a literature review of the laryngeal neuroendocrine neoplasms. Included is a review of all four neuroendocrine neoplasms, taking a close look at a comparison between laryngeal paragangliomas and atypical carcinoids tumors. All cases of subglottic laryngeal paragangliomas reported in the literature were also compiled and tabulated. METHODS The patient's record was reviewed for age, symptomatology, workup, and surgical procedures performed. RESULTS The patient was disease free 36 months after undergoing a tracheostomy for airway control, followed by a cricoid split for complete excision of the tumor. CONCLUSIONS It is important to differentiate among the four laryngeal neuroendocrine neoplasms, especially between atypical carcinoids and paragangliomas. Each tumor requires different treatments, with the former requiring a more aggressive approach. Paragangliomas must be completely excised to prevent their recurrence, and this approach should be considered a curative treatment. In addition, the immunohistochemical battery is of paramount importance in obtaining the correct pathological diagnosis.
Collapse
Affiliation(s)
- Robert Maisel
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical School and Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA
| | | | | |
Collapse
|
16
|
Abstract
Small cell carcinoma of the larynx is an uncommon epithelial tumor, which is the most aggressive subtype of neuroendocrine carcinomas. Because of its nonspecific clinical and radiological manifestations, the diagnosis of small cell carcinoma of the larynx is essentially based on the light microscopic examination aided by electron microscopy or immunohistochemical staining. We report a case of supraglottic small cell carcinoma accompanied by large bilateral cervical lymph node metastasis ocurring in a 70-year-old man. On CT scans, no area of low attenuation indicating necrosis was demonstrated within such large metastatic lymph nodes. We suggest that small cell carcinoma of the larynx should be included in the diagnostic considerations when a laryngeal mass is accompanied by large cervical lymph nodes without necrosis shown by CT.
Collapse
Affiliation(s)
- H J Kim
- Department of Diagnostic Radiology and Institute of Cancer Research, Gyeongsang National University Hospital, South Korea
| | | |
Collapse
|
17
|
Ozünlü A, Dündar A, Satar B, Günhan O. Laryngeal paraganglioma. A review and report of a single case. J Laryngol Otol 1996; 110:519-26. [PMID: 8763368 DOI: 10.1017/s0022215100134164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Laryngeal paraganglioma originates in the neural crest cells in the laryngeal paraganglia. Two distinct types may be cited on the basis of clinical features, but biopsy is essential for diagnosis. By light microscopy, the Zellballen pattern appears pathognomonic. The treatment consists of surgical excision. In this article, due to the rareness of the tumour, one case of laryngeal paraganglioma is presented. The general knowledge and the available literature are reviewed. The difficulties in the differential diagnosis are stressed and treatment principles are discussed.
Collapse
Affiliation(s)
- A Ozünlü
- Department of Otorhinolaryngology, Gülhane Military Medical Academy, Etlik-Ankara, Turkey
| | | | | | | |
Collapse
|
18
|
Yoshida H, Onizawa K, Hirohata H. Neuroendocrine carcinoma of the tongue: report of a case. J Oral Maxillofac Surg 1995; 53:823-7. [PMID: 7595799 DOI: 10.1016/0278-2391(95)90342-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- H Yoshida
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, University of Tsukuba, Japan
| | | | | |
Collapse
|
19
|
Hunsicker RC, Koch TJ, Folander H. Superselective Embolization in Two Cases of Laryngeal Paraganglioma. Otolaryngol Head Neck Surg 1995; 113:126-30. [PMID: 7603706 DOI: 10.1016/s0194-59989570155-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- R C Hunsicker
- Department of Surgery, St. Luke's Hospital, Bethelehem, PA, USA
| | | | | |
Collapse
|
20
|
Ferlito A, Barnes L, Wenig BM. Identification, classification, treatment, and prognosis of laryngeal paraganglioma. Review of the literature and eight new cases. Ann Otol Rhinol Laryngol 1994; 103:525-36. [PMID: 8024215 DOI: 10.1177/000348949410300705] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study details the clinicopathologic features of 62 cases of laryngeal paraganglioma (LP), including 54 acceptable cases identified in the literature (although clinical information is lacking on 7 of these) and 8 previously unpublished cases identified from the Registry of Otolaryngic-Endocrine Pathology at the Armed Forces Institute of Pathology. Demographic findings show that the overwhelming majority of cases affect women (41:14), mainly in the fourth to sixth decades of life (age range, 14 to 83 years; median, 44 years), with a prevalence in the supraglottic larynx. These neoplasms are treated by surgical resection and are benign. Despite the characteristic pathologic features associated with LP, it is sometimes confused with other neoplasms, particularly neuroendocrine carcinomas of the larynx, and this confusion leads to unfortunate designations such as malignant paraganglioma and metastasizing paraganglioma of the larynx. Judging from the cases reported in this study and those identified in the literature, we conclude that malignant biologic behavior associated with LP is extraordinarily rare (< 2%). Because of the misdiagnoses of LP, the prognosis associated with this entity has been skewed to suggest that LP may behave aggressively. This has led to the inappropriate classification of LP among the malignant categories of laryngeal neuroendocrine neoplasms. The goal of this study is to detail the features diagnostic of LP and to discuss the appropriate treatment, prognosis, and classification of these neoplasms.
Collapse
Affiliation(s)
- A Ferlito
- Department of Otolaryngology, University of Padua, Italy
| | | | | |
Collapse
|
21
|
|