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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
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Ngo DQ, Ngo QX, Van Le Q. A Typical Carcinoid of the Nasopharynx. Ear Nose Throat J 2019; 99:34-36. [PMID: 30832504 DOI: 10.1177/0145561319834516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Duy Quoc Ngo
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Quy Xuan Ngo
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Quang Van Le
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
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López F, Hunt JL, Nixon IJ, Rinaldo A, Williams MD, Cardesa A, Ferlito A. How phenotype guides management of the neuroendocrine carcinomas of the larynx. J Laryngol Otol 2018; 132:568-74. [DOI: 10.1017/s0022215118000968] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractObjectiveThis review aimed to critically analyse data pertaining to the clinical presentation and treatment of neuroendocrine carcinomas of the larynx.MethodA PubMed search was performed using the term ‘neuroendocrine carcinoma’. English-language articles on neuroendocrine carcinoma of the larynx were reviewed in detail.Results and conclusionWhile many historical classifications have been proposed, in contemporary practice these tumours are sub-classified into four subtypes: carcinoid, atypical carcinoid, small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma. These tumours exhibit a wide range of biological behaviour, ranging from the extremely aggressive nature of small and large cell neuroendocrine carcinomas, which usually have a fatal prognosis, to the less aggressive course of carcinoid tumours. In small and large cell neuroendocrine carcinomas, a combination of irradiation and chemotherapy is indicated, while carcinoid and atypical carcinoid tumour management entails conservation surgery.
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Smetak MR, Khariwala SS, Cayci Z, Yueh B, Racila E. Primary calcitonin-secreting neuroendocrine carcinoma of the larynx - Case report and update on current terminology. Otolaryngology Case Reports 2018; 6:61-65. [DOI: 10.1016/j.xocr.2018.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Affiliation(s)
- Arsheed H Hakeem
- From the Department of Head and Neck Oncology, Prince Aly Khan Hospital, Mumbai, India
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Wang KR, Jia YJ, Zhou SH, Wang QY, Bao YY, Feng ZY, Yao HT, Fan J. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids: Case Report and Review of the Literature. Medicine (Baltimore) 2016; 95:e2796. [PMID: 26886629 PMCID: PMC4998629 DOI: 10.1097/md.0000000000002796] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No optimal treatment for such metastases has yet been defined.
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Affiliation(s)
- Kui-Rong Wang
- From the Department of Anaesthesia (K-RW, Z-YF); Department of Otolaryngology (Y-JJ, S-HZ, Q-YW, Y-YB); Department of Pathology (H-TY); and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province, China (JF)
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Iqbal MS, Paleri V, Moor J, Dobrowsky W, Kelly C, Kovarik J. Small cell neuroendocrine carcinoma of larynx: case series and literature review. J Laryngol Otol 2015; 129:910-5. [DOI: 10.1017/s0022215115001668] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Primary small cell neuroendocrine carcinoma of larynx is a rare, aggressive type of malignancy. As only about 200 cases worldwide have been reported, any larger institutional experience is valuable. This study reports our experience in managing this rare entity.Methods:Of the nine patients identified, three had metastatic cancer at the time of diagnosis. Four patients underwent radical treatment: one was managed surgically followed by adjuvant chemotherapy and consolidation radiotherapy; the remaining three were treated with neoadjuvant chemotherapy and definitive radiotherapy.Results:Of the 4 patients treated with radical intent, 1 was alive and disease free after 99 months, 2 died of metastatic disease after 22 and 26 months, and 1 was alive after 20 months with a diagnosis of recurrent disease.Conclusion:Our relatively small number of patients confirms other centres' experiences. This cancer has a poorer prognosis than most other head and neck cancers. Although the logistics would be challenging, there is a need for international multicentre trials for this disease modelled on those performed for other cancers, as has been done for paediatric malignancies.
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Patel TD, Vazquez A, Dubal PM, Baredes S, Liu JK, Eloy JA. Sinonasal neuroendocrine carcinoma: a population-based analysis of incidence and survival. Int Forum Allergy Rhinol 2015; 5:448-53. [DOI: 10.1002/alr.21497] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/05/2014] [Accepted: 12/30/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Tapan D. Patel
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Alejandro Vazquez
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Pariket M. Dubal
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
| | - James K. Liu
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark NJ
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van der Laan TP, Plaat BEC, van der Laan BFAM, Halmos GB. Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases. Head Neck 2014; 37:707-15. [PMID: 24596175 DOI: 10.1002/hed.23666] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 12/14/2013] [Accepted: 03/02/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Current recommendations on the treatment of neuroendocrine carcinoma of the larynx (NCL) are based on anecdotal evidence. With this meta-analysis, our purpose was to provide clinicians with more substantiated guidelines in order to improve the treatment outcome of the patients affected with NCL. METHODS A structured literature search for all research concerning NCL was performed against the MEDLINE and EMBASE databases. Available data was normalized, pooled, and statistically analyzed. RESULTS Four hundred thirty-six cases of NCL were extracted from 182 studies, of which 23 were typical carcinoid, 163 were atypical carcinoid, 183 were small-cell neuroendocrine carcinoma, 29 were large-cell neuroendocrine carcinoma, and 38 were unspecified carcinoid tumors. The 5-year disease-specific survival (DSS) was 100% for typical carcinoid, 53% for atypical carcinoid, 19% for small-cell neuroendocrine carcinoma, and 15% for large-cell neuroendocrine carcinoma (p < .001). Patients with an atypical carcinoid treated with surgery had better DSS than those treated with radiotherapy (60% vs 54%; p = .035). Postoperative radiotherapy did not result in better DSS in atypical carcinoid. Patients with an atypical carcinoid, not undergoing surgical treatment of the neck, developed isolated regional recurrence in 30% of cases (p = .001). Radiochemotherapy yielded the best DSS for small-cell neuroendocrine carcinoma compared to other modalities (31% vs 13%; p = .001). CONCLUSION Typical carcinoid can be treated by local excision alone. Atypical carcinoids do not seem to respond well to radiotherapy and are best managed through radical surgical excision in combination with elective neck dissection. Patients with small-cell neuroendocrine carcinoma or large-cell neuroendocrine carcinoma seem to benefit most from chemoradiotherapy.
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Affiliation(s)
- Tom P van der Laan
- Department of Otolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Abstract
Carcinoid (neuroendocrine) tumors of the head and neck rarely occur outside the larynx and, until now, none has been reported in the oral cavity. We describe what we believe is the first reported case of an atypical carcinoid tumor, or any other type of neuroendocrine carcinoma, of the uvula.
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Affiliation(s)
- Nelson C Goldman
- Division of Oral & Maxillofacial Surgery, Department of Surgery, University of Florida College of Medicine, 653 W. 8th St., Jacksonville, FL 32209, USA.
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Likhacheva A, Rosenthal DI, Hanna E, Kupferman M, Demonte F, El-Naggar AK. Sinonasal neuroendocrine carcinoma: impact of differentiation status on response and outcome. Head Neck Oncol 2011; 3:32. [PMID: 21794118 PMCID: PMC3154852 DOI: 10.1186/1758-3284-3-32] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 07/27/2011] [Indexed: 11/30/2022]
Abstract
Background The impact of tumor differentiation on the behavior and response of sinonasal neuroendocrine carcinoma is unknown. Methods We performed a retrospective review of the patients treated for neuroendocrine carcinoma (NEC) of the nasal cavity or paranasal sinuses from 1992 to 2008 at MDACC. Results The results of our study suggest that pathologic differentiation may not be a critical factor in the clinical management of patients with NEC of the sinonasal tract. This is in contrast to laryngeal and lung NEC for which pathological differentiation has traditionally guided clinical management. Conclusion Mutlimodality approach should be the cornerstone of treating sinonasal NEC regardless of their differentiation. Specifically, RT may provide durable local control for patients with moderately differentiated NEC if resection is not feasible or desirable, while surgical resection can benefit patients with chemo-resistant or radio-resistant disease.
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Affiliation(s)
- Anna Likhacheva
- Department of Radian Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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Furuta A, Kudo M, Kanai KI, Ohki S, Suzaki H. Typical carcinoid tumor arising in the nose and paranasal sinuses--case report. Auris Nasus Larynx 2009; 37:381-5. [PMID: 19900773 DOI: 10.1016/j.anl.2009.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 07/17/2009] [Accepted: 09/13/2009] [Indexed: 11/26/2022]
Abstract
Carcinoid tumors arise from neuroendocrine cells, many of which are present in the digestive tract and lungs. There have been few reports of carcinoid tumors occurring in the nose and paranasal sinus area, and they are very rare. We encountered a patient with a carcinoid tumor that arose in the nose and paranasal sinuses, and we report the case with a review of the literature. The patient was a 75-year-old woman who began to experience right-sided nasal obstruction, and when her nose began to bleed on the right-side she was examined in our department. A tumor lesion that easily bled and had filled the right nasal cavity was observed. CT revealed a mass lesion with a marked contrast enhancement in the right nasal cavity, ethmoid sinus, and sphenoid sinus, and MRI showed numerous flow voids in the interior that seemed to be tumor blood vessels. The tumor was excised through a lateral rhinotomy. The histopathological diagnosis was a carcinoid tumor. Tumor recurrence was subsequently detected in the vicinity of the opening of the sphenoid sinus, and because the tumor was tending to grow larger, the tumor was resected. The patient has been followed up in the outpatient clinic, recurrence-free.
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Affiliation(s)
- Atsuko Furuta
- Department of Otorhinolaryngology, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawaku, Tokyo, Japan.
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Oukabli M, Blechet C, Harket A, Gaillard F, Garand G, Fetissof F. Carcinoïde atypique de l’aryténoïde : à propos de six observations. Ann Pathol 2008; 28:2-8. [DOI: 10.1016/j.annpat.2008.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2008] [Indexed: 11/21/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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Affiliation(s)
- Alfio Ferlito
- Department of Surgical Sciences, ENT Clinic, University of Udine, Policlinico Universitario, Piazzale S. Maria della Misericordia, I-33100 Udine, Italy.
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Barbeaux A, Duck L, Weynand B, Desuter G, Hamoir M, Gregoire V, Baurain JF, Machiels JP. Primary combined squamous and small cell carcinoma of the larynx: Report of two cases and discussion of treatment modalities. Eur Arch Otorhinolaryngol 2006; 263:786-90. [PMID: 16718502 DOI: 10.1007/s00405-006-0060-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2005] [Accepted: 11/15/2005] [Indexed: 12/30/2022]
Abstract
Combined small cell carcinoma (SMCC) of the larynx consists of SMCC admixed with a component of squamous cell carcinoma or adenocarcinoma. These tumors are very rare and, to date, only a few cases have been fully described. This points out the lack of information available about the correct management of these patients. Here, we describe two additional cases of combined SMCC of the larynx that illustrate the difficulties that we can encounter to diagnose correctly these patients and, by consequence, to treat them adequately.
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Affiliation(s)
- Annelore Barbeaux
- Unité d'Oncologie Médicale, Clinique de Cancérologie Cervico-Maxillo-Faciale, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10, Av. Hippocrate, 1200, Brussels, Belgium
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Abstract
Seven patients with typical or atypical pulmonary carcinoid tumors overdiagnosed as small-cell carcinoma on bronchoscopic biopsies are described. Bronchial biopsies from 9 consecutive small-cell lung carcinoma patients were used as control group for histologic and immunohistochemical studies (cytokeratins, chromogranin A, synaptophysin, Ki-67 [MIB-1], and TTF-1). The carcinoid tumors presented as either central or peripheral lesions composed of tumor cells with granular, sometimes coarse chromatin pattern, high levels of chromogranin A/synaptophysin immunoreactivity, and low (<20%) Ki-67 (MIB-1) labeling index. The tumor stroma contained thin-walled blood vessels. Small-cell carcinomas always showed central tumor location, finely dispersed nuclear chromatin, lower levels of chromogranin A/synaptophysin, and high (>50%) Ki-67 (MIB-1) labeling index. The stroma contained thick-walled blood vessels with glomeruloid configuration. Judging from this study, overdiagnosis of carcinoid tumor as small-cell carcinoma in small crushed bronchial biopsies remains a significant potential problem in a worldwide sample of hospital settings. Careful evaluation of hematoxylin and eosin sections remains the most important tool for the differential diagnosis, with evaluation of tumor cell proliferation by Ki-67 (MIB-1) labeling index emerging from our review as the most useful ancillary technique for the distinction.
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Affiliation(s)
- Giuseppe Pelosi
- Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan School of Medicine, Milan, Italy.
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Chang KP, Lee LY, Yeh ARM, Dai TS, Hao SP. Endoscopic CO2 laser surgery for an atypical carcinoid tumor of the epiglottis masquerading as a supraglottic cyst. Head Neck 2005; 27:1004-7. [PMID: 16114009 DOI: 10.1002/hed.20260] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Atypical carcinoid tumor is a neuroendocrine tumor; its occurrence in the larynx is uncommon, and clinical manifestations are rare. We report an unusual case of atypical carcinoid tumor of the epiglottis mimicking a supraglottic retention cyst. METHODS A 44-year-old woman complained of an intermittent globus sensation of the throat of 2 years' duration. A 1.0- x 0.8-cm cystic lesion was found over the tip of the epiglottis. A supraglottic retention cyst was initially diagnosed, and the patient was treated medically. Her symptoms persisted, so we performed a laryngoscopic biopsy, which suggested an atypical carcinoid tumor. RESULTS Transoral endoscopic CO2 laser surgery and bilateral elective neck dissection were subsequently performed. The 2-year follow-up did not reveal any locoregional recurrence or distant metastasis. CONCLUSIONS This aggressive neoplasm may cause only a few, unremarkable symptoms and masquerade as a supraglottic cyst. Endoscopic CO2 laser surgery can be used to resect this uncommon tumor, with oncologically sound results and without surgical morbidity.
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Affiliation(s)
- Kai-Ping Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, 14F, No.16, Alley 4, Lane 137, Min-Sheng E. Rd. Sec. 5, Taipei, Taiwan
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Ottinetti A, Colombo E, Dardano F, Migliora P, Picciotto F, Zaccagna A, Angeli G. Cutaneous metastasis of neuroendocrine carcinoma of the larynx: report of a case. J Cutan Pathol 2003; 30:512-5. [PMID: 12950503 DOI: 10.1034/j.1600-0560.2003.00062.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cutaneous metastasis from neuroendocrine carcinomas of visceral origin is rarely described in indexed literature. The primary sites of origin include: lung (Wick et al., J Am Acad Dermatol 1985; 13: 134), larynx (Zambruno et al., Ann Dermatol Venereol 1989; 116: 855; Schmidt et al., J Laryngol Otol 1994; 108: 272; Guerzider et al., Ann Pathol 1991; 11 (4): 253), mediastinum (Yoshimasu et al., J Dermatol 2001; 28 (3): 168), uterus (Fogaca et al., J Cutan Pathol 1993; 20: 455), and thymus (Wick et al., J Am Acad Dermatol 1985; 13: 134). METHODS In this report, the authors present the clinical, histological, immunohistochemical, and ultrastructural characteristics of secondary skin localizations of a neuroendocrine laryngeal tumor that occurred in a 61-year-old man. The complete follow up of the case is described and a brief revision of the terminology and classification of neuroendocrine neoplasms of the larynx is discussed, since a significant relationship exists between the degree of differentiation and biological behavior. RESULTS On histological examination, the secondary cutaneous localization appeared to be more dedifferentiated compared to the primary tumor. The immunohistochemical patterns of reactivity were similar in both neoplasms, showing expression of neuroendocrine and epithelial markers. CONCLUSIONS An important issue of prognostic significance is to differentiate a cutaneous metastasis of a neuroendocrine carcinoma from the primary small cell-undifferentiated carcinoma of the skin (Merkel cell carcinoma).
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Affiliation(s)
- A Ottinetti
- Department of Pathology, Ospedale S. Andrea, Vercelli, Italy.
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Abstract
We report a rare case of moderately differentiated neuroendocrine carcinoma of the larynx. We describe the clinical and pathologic findings relevant to this case, and we review the literature on the pathologic features of this malignancy. We also discuss treatment options.
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Affiliation(s)
- Larry Shemen
- Department of Surgery, New York Hospital Medical Center of Queens, Flushing, N.Y
| | - Peter Petratos
- Department of Surgery, New York Hospital Medical Center of Queens, Flushing, N.Y
| | - Suketu Patel
- Department of Surgery, New York Hospital Medical Center of Queens, Flushing, N.Y
| | - Laurie Horowitz
- Department of Pathology, New York Hospital Medical Center of Queens, Flushing, N.Y
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McBride LC, Righi PD, Krakovitz PR. Case study of well-differentiated carcinoid tumor of the larynx and review of laryngeal neuroendocrine tumors. Otolaryngol Head Neck Surg 1999; 120:536-9. [PMID: 10187951 DOI: 10.1053/hn.1999.v120.a85070] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L C McBride
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, USA
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Abstract
Neuroendocrine neoplasms of the larynx have been divided into those of epithelial or neural origin. The latter consist of paragangliomas while the epithelial origin group can be divided into the typical and atypical carcinoids and small cell neuroendocrine carcinomata, the latter consisting of the oat cell type, the intermediate cell type and the combined cell type. There are now over 500 cases of neuroendocrine neoplasms of the larynx in the literature. The diagnosis is primarily based on light microscopy, and, in some instances, it may be supported by special histochemical studies. It should be confirmed by immunocytochemical and/or ultrastructural investigation. The different biological behaviour of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on diagnostic accuracy. Typical carcinoid is an extremely rare lesion. It is treated preferably by conservative surgery; elective neck dissection is not necessary because of the lack of lymph node metastases at diagnosis. Chemotherapy and/or radiotherapy have not been effective in the limited number of patients treated thus far. Prognosis is excellent with cure following surgery. Atypical carcinoid is the most frequent non-squamous carcinoma of the larynx. The mainstay of treatment is surgery. Elective neck dissection should be performed because of the high likelihood of cervical lymph node metastases. Primary radiation therapy with adjuvant chemotherapy is not indicated. The survival rate is 48 per cent at five years and 30 per cent at 10 years. Although the larynx is one of its most common extrapulmonary sites, small cell neuroendocrine carcinoma is still a rare tumour. Surgical results for this tumour have been disappointing and is reserved for cases of local relapse with no evidence of metastasis. Chemotherapy and radiotherapy currently appear to offer the least disabling and most effective forms of therapy. The two- and five-year survival rates are 16 per cent and five per cent, respectively. Paraneoplastic syndromes have occasionally been reported in association with carcinoid tumours (typical and atypical) and small cell neuroendocrine carcinoma. There have been also rare reports of an elevated neuropeptide serum level. Paraganglioma is the only laryngeal neuroendocrine neoplasm with a female preponderance (3:1). Confusion with atypical carcinoid has led to incorrect diagnosis and inappropriate classification schemes, erroneously suggesting that laryngeal paraganglioma has the potential for aggressive behaviour. Conservative surgery represents the treatment of choice; elective neck dissection is not necessary, and the prognosis is excellent.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Italy
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Abstract
An overview of the impact of the phenotype on treatment and prognosis of different laryngeal malignancies is presented.
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MESH Headings
- Carcinoid Tumor/mortality
- Carcinoid Tumor/therapy
- Carcinoma, Adenoid Cystic/mortality
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Basal Cell/mortality
- Carcinoma, Basal Cell/therapy
- Carcinoma, Mucoepidermoid/mortality
- Carcinoma, Mucoepidermoid/therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/therapy
- Carcinoma, Verrucous/mortality
- Carcinoma, Verrucous/therapy
- Chondrosarcoma/mortality
- Chondrosarcoma/therapy
- Humans
- Laryngeal Neoplasms/mortality
- Laryngeal Neoplasms/therapy
- Lymphoma/mortality
- Lymphoma/therapy
- Melanoma/mortality
- Melanoma/therapy
- Survival Rate
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Italy.
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24
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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.
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Affiliation(s)
- H J Kim
- Department of Diagnostic Radiology and Institute of Cancer Research, Gyeongsang National University Hospital, South Korea
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