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Chen Y, Zhou N, Huang C, He X, Wang X, Tang H, Wang W, Wang J, Li T, Guo D. EBV-positive small cell neuroendocrine carcinoma of nasopharynx as a probably unique subtype of neuroendocrine carcinoma: a clinicopathologic study of three cases and literature review. Diagn Pathol 2024; 19:101. [PMID: 39049067 PMCID: PMC11267672 DOI: 10.1186/s13000-024-01526-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND There is currently scarcity of information on small cell neuroendocrine carcinoma of the nasopharynx (SCNEC-nasopharynx). It is believed that this type of cancer is not associated with Epstein-Barr virus (EBV) infection and is indistinguishable from classic SCNEC occurring in other organs. MATERIALS AND METHODS Herein we provided 3 cases of nasopharyngeal mass in our hospital, two males and one female. On admission, these patients were considered nasopharyngeal carcinoma with lymph node metastasis, and one of them had liver metastasis. The nasopharyngeal mucosal tissues were biopsied for pathological examination including immunohistochemistry and in situ hybridization. PubMed database was searched for articles about SCNEC-nasopharynx published up to April 2024 in any language. RESULT The 3 cases had similar histological features of SCNEC in other organs but differed in rich- tumor-infiltrating lymphocytes (TILs). All of them stained for pancytokeratin (panCK) and epidermal growth factor receptor (EGFR). Case 1 and Case 2 diffusely expressed insulinoma-associated protein 1(INSM-1) and synaptophysin (Syn), Case 3 strongly stained for CD56 and Syn. Immunostaining of all 3 cases for p40, p63, TTF-1, CK20, S-100 and NUT showed negative. BRG-1, INI-1 and Rb were retained. And p53 all showed wild-type expression. The Ki-67 labeling indiced of case 1, 2, and 3 were 80%, 90%, and 80%, respectively. In situ hybridization showed strong and uniform nuclear positivity of EBV-encoded small RNAs (EBER) in the neoplastic cells of 3 cases. CONCLUSION EBV-positive SCNEC-nasopharynx was exactly rare. The origin of this tumor is still controversial. It may originate from EBV-infected mucosal epithelium like nasopharyngeal carcinoma. Based on our cases and relevant literature, we found EBV-positive SCNEC-nasopharynx as a probably site-specific subtype of SCNEC with differing pathogenetic mechanism. The subtype not only virus positivity but also that it was associated with TILs and did not show p53 or Rb alterations by immunohistochemistry. It may be more responsive to treatment and have a better prognosis than classic SCNEC. We will continue to follow-up these patients and collect additional cases to further understand the unique biology of this rare solid tumor.
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Affiliation(s)
- Ying Chen
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Ning Zhou
- Departments of Pathology, Sichuan Province, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Caijun Huang
- Departments of Imaging, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Xin He
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Xiaodong Wang
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Hao Tang
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Wenyan Wang
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Jiashuang Wang
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China
| | - Tao Li
- Departments of Pathology, Sichuan Province, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Deyu Guo
- Departments of Pathology, Guiqian International General Hospital, Guiyang, Guizhou Province, China.
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2
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AlQudah L, Hackman T, Brownlee A. Oropharyngeal Mixed Neuroendocrine-Nonneuroendocrine Neoplasm (MiNEN): A Case Report and Literature Review. Head Neck Pathol 2024; 18:53. [PMID: 38896312 PMCID: PMC11187043 DOI: 10.1007/s12105-024-01660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024]
Abstract
Mixed neuroendocrine-nonneuroendocrine (MiNEN) neoplasms in the head and neck are exceptionally rare biphasic tumors with unclear pathogenesis and an aggressive clinical behavior. This is the first reported case of an oropharyngeal MiNEN with the nonneuroendocrine component being an HPV-associated adenocarcinoma. The tumor arose in a 56 year-old male with history of long-term cigarette smoking and was composed of an adenocarcinoma intermixed with a small cell neuroendocrine carcinoma. P16 immunohistochemical stain and HPV16/18 in-situ hybridization were strongly and diffusely expressed in both components.
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Affiliation(s)
- Leen AlQudah
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, USA.
| | - Trevor Hackman
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, USA
| | - Amy Brownlee
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, USA
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3
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Wang J, Fan Y, Chen XD, Xue T, Chen FQ. Primary Small Cell Carcinoma in Nasal Cavity and Paranasal Sinuses: 15 Cases From a Single Center. EAR, NOSE & THROAT JOURNAL 2024; 103:227-233. [PMID: 34625002 DOI: 10.1177/01455613211049853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Small cell carcinoma (SCC) in the nasal cavity and sinuses is extremely rare. The clinical data of 15 patients with primary SCC in nasal cavity and sinuses were analyzed retrospectively. All patients were treated with surgery, radiotherapy, and chemotherapy. Of the 15 patients, 2 patients are alive for more than 6 years, and 5 patients died after the median follow-up period (11 months). Most of our patients represent the later stage (73% presented at stage III or IV) and had surgery combined with radiotherapy and chemotherapy; however, nearly half of patients have tumor recurrence and/or distant metastasis. SCC of nasal cavity and sinuses often invades surrounding tissues, and the long-term curative rate is generally low. Early diagnosis and comprehensive treatment are key to improve survival. Although the overall survival time of SCC is not optimistic, it is still recommended that patients take comprehensive treatment.
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Affiliation(s)
- Jian Wang
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yingying Fan
- Center for Mitochondrial Biology and Medicine and Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiao-Dong Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Tao Xue
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fu-Quan Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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4
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Marak JR, Chauhan A, Anand N, Khurana R. Primary Small Cell Neuroendocrine Carcinoma of nasopharynx with metastatic cervical lymph nodes: an exceedingly rare entity with review of literature. BMJ Case Rep 2023; 16:e255695. [PMID: 37758655 PMCID: PMC10537850 DOI: 10.1136/bcr-2023-255695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Small cell neuroendocrine carcinoma of nasopharynx is extremely rare and displays aggressive nature with a poor prognosis. Neuroendocrine tumours rarely arise from the head and neck region and pose a diagnostic and management challenge. In English literature, only 16 cases of primary small cell neuroendocrine carcinoma of nasopharynx have been reported so far; and to the best of our knowledge, this is the seventeenth case and second in the younger age group. Here, we report the case of an adolescent male patient who presented with nasal blockage, repeated episodes of epistaxis and neck swellings. After proper diagnostic workup, the diagnosis of small cell neuroendocrine carcinoma of nasopharynx was made. The patient was treated with chemotherapy, followed by radiotherapy. Imaging investigation executed after the end of the treatment exhibited complete remission of the disease. The patient is kept under active surveillance with no signs of relapse at present.
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Affiliation(s)
- James R Marak
- Radiodiagnosis, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Abhishek Chauhan
- Radiodiagnosis, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Nidhi Anand
- Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
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5
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Cabezas-Camarero S, García-Barberán V, Benítez-Fuentes JD, Sotelo MJ, Plaza JC, Encinas-Bascones A, De-la-Sen Ó, Falahat F, Gimeno-Hernández J, Gómez-Serrano M, Puebla-Díaz F, De-Pedro-Marina M, Iglesias-Moreno M, Pérez-Segura P. Clinical Behavior, Mutational Profile and T-Cell Repertoire of High-Grade Neuroendocrine Tumors of the Head and Neck. Cancers (Basel) 2023; 15:cancers15092431. [PMID: 37173898 PMCID: PMC10177201 DOI: 10.3390/cancers15092431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Neuroendocrine carcinomas (NECs) of the head and neck (HN) account for <1% of HN cancers (HNCs), with a 5-year overall survival (OS) <20%. This is a retrospective study of HN NECs diagnosed at our institution between 2005 and 2022. Immunohistochemistry and next-generation sequencing (NGS) were used to evaluate neuroendocrine markers, tumor mutational burden (TMB), mutational profiles and T-cell receptor repertoires. Eleven patients with high-grade HN NECs were identified (male:female ratio 6:5; median age 61 (Min-Max: 31-86)): nasoethmoidal (3), parotid gland (3), submaxillary gland (1), larynx (3) and base of tongue (1). Among n = 8 stage II/IVA/B, all received (chemo)radiotherapy with/without prior surgery or induction chemotherapy, with complete response in 7/8 (87.5%). Among n = 6 recurrent/metastatic patients, three received anti-PD1 (nivolumab (2), pembrolizumab (1)): two achieved partial responses lasting 24 and 10 months. After a median follow-up of 30 and 23.5 months since diagnosis and since recurrent/metastatic, median OS was not reached. Median TMB (n = 7) was 6.72 Mut/Mb. The most common pathogenic variants were TP53, HNF1A, SMARCB1, CDKN2A, PIK3CA, RB1 and MYC. There were 224 median TCR clones (n = 5 pts). In one patient, TCR clones increased from 59 to 1446 after nivolumab. HN NECs may achieve long-lasting survival with multimodality treatment. They harbor moderate-high TMBs and large TCR repertoires, which may explain responses to anti-PD1 agents in two patients and justify the study of immunotherapy in this disease.
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Affiliation(s)
- Santiago Cabezas-Camarero
- Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Vanesa García-Barberán
- Molecular Oncology Laboratory, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Javier David Benítez-Fuentes
- Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Miguel J Sotelo
- Medical Oncology Department, Aliada Cancer Center, Lima 15036, Peru
- Medical Oncology Department, Clínica San Felipe, Lima 15072, Peru
- Medical Oncology Department, Hospital María Auxiliadora, Lima 15801, Peru
| | - José Carlos Plaza
- Pathology Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | | | - Óscar De-la-Sen
- Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Farzin Falahat
- Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Jesús Gimeno-Hernández
- Otolaryngology-Head and Neck Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Manuel Gómez-Serrano
- Otolaryngology-Head and Neck Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Fernando Puebla-Díaz
- Radiation Oncology Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Manuel De-Pedro-Marina
- Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maricruz Iglesias-Moreno
- Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Pedro Pérez-Segura
- Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
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6
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Longo R, Colin S, Streiff C, Benichou CG, Wendel C, Campitiello M, Plastino F, Bastien C, Egea J. A primary small cell neuroendocrine carcinoma (SCNC) of the oral cavity (cheek mucosa): Description of a case report. Oral Oncol 2023; 137:106295. [PMID: 36565487 DOI: 10.1016/j.oraloncology.2022.106295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Small cell neuroendocrine carcinoma (SCNC) of the oral cavity is a poorly differentiated, high-grade and very aggressive tumor with a poor prognosis. CASE DESCRIPTION A 64-year-old, Caucasian, smoker man consulted for an ulcero-necrotic, exophytic, lesion of the right retromolar trigone. Haed&neck CT scan showed a right tonsillar tumor lesion. The 18F-PET scan confirmed the presence of a right, highly hypermetabolic tonsillar lesion and two homolateral, cervical lymph nodes. Histology and immunohistochemistry were consisted with the diagnosis of a primary SCNC of the oral cavity. As the tumor was locally advanced and unresectable, the patient underwent a definitive radio-chemotherapy with a cisplatin/etoposide combined regimen (4 cycles). The treatment was well tolerated and led to a complete tumor response. CONCLUSION The particularity of this case relies on the rarity of the oral SCNC, its difficult and challenging diagnosis, and the complexity of its management that is not validated by large clinical trials, data being extrapolated from small cell lung cancer. In our case, the patient presenting a locally advanced tumor was treated by a combined radio-chemiotherapy leading to a complete tumor regression. The patient's follow up is too short to assess the real benefit of this treatment on overall survival.
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Affiliation(s)
- Raffaele Longo
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Sebastien Colin
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Camille Streiff
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Claire Gamelon Benichou
- Division of Radiotherapy, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Chloé Wendel
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Marco Campitiello
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Francesca Plastino
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Claire Bastien
- Division of Pathology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
| | - Julie Egea
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085 Ars-Laquenexy, France.
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7
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Mesolella M, Allosso S, Varricchio S, Russo D, Pignatiello S, Buono S, Motta G. Small-Cell Carcinoma of Nasopharynx: A Case Report of Unusual Localization. EAR, NOSE & THROAT JOURNAL 2023; 102:NP13-NP18. [PMID: 33371727 DOI: 10.1177/0145561320973780] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Neuroendocrine tumors are a spectrum of rare and highly heterogeneous neoplasms with distinct functional and biological behavior in relation to location, tumor size, and histological differentiation. Neuroendocrine tumors arise from the neuroendocrine cells of the diffuse neuroendocrine system located in almost every organ. Neuroendocrine tumors in the head and neck district are usually reported in sinonasal cavities and larynx. We present the case of a nasopharyngeal small-cell neuroendocrine carcinoma, which, as far as we know, is the 16th case reported in literature.
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Affiliation(s)
- Massimo Mesolella
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Salvatore Allosso
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Sarah Buono
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Gaetano Motta
- Unit of Otorhinolaryngology, University Luigi Vanvitelli, Napoli, Italy
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8
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Lin YW, Ting CH, Chen TY, Leu YS. Nasopharyngeal Large Cell Neuroendocrine Carcinoma Synchronized With Nasopharyngeal Squamous Cell Carcinoma: A Case Report and Review of Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221138210. [PMID: 36345713 DOI: 10.1177/01455613221138210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Neuroendocrine carcinomas (NECs) are poorly differentiated neuroendocrine tumors of the upper respiratory tract. We present an extremely rare case of nasopharyngeal large cell neuroendocrine carcinoma (LCNEC) synchronized with nasopharyngeal squamous cell carcinoma (SCC). Both SCC and LCNEC are associated with Epstein-Barr virus (EBV) infection, supported by the positive result of Epstein-Barr encoding region in-situ hybridization. Strong correlation is found between EBV infection and nasopharyngeal malignancies. Furthermore, the EBV status might be a crucial prognostic factor in nasopharyngeal LCNEC. EBV-positive LCNEC is effective to chemoradiotherapy, and may have preferable outcome than EBV-negative LCNEC arising in the nasopharynx or other sites. The recognition of the EBV status is important for patients to receive appropriate treatment.
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Affiliation(s)
- Yu-Wen Lin
- Department of Otolaryngology-Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ching-Heng Ting
- Department of Pathology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Tung-Ying Chen
- Department of Pathology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yi-Shing Leu
- Department of Otolaryngology-Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
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9
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Froehlich MH, Shih MC, Shehee L, Kompelli AR, Aylward A, Nguyen SA, Kaczmar JM, Nathan CA, Day T, Neskey DM. Systematic review of neuroendocrine carcinomas of the oropharynx. Head Neck 2022; 44:1725-1736. [PMID: 35437851 DOI: 10.1002/hed.27055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/15/2022] [Accepted: 03/28/2022] [Indexed: 11/05/2022] Open
Abstract
Data describing features and management of oropharyngeal neuroendocrine carcinomas (NEC) remain sparse. A systematic review was performed. Patients were stratified by treatment modality and examined for disease progression and survival outcomes. Ninety-four patients from 50 publications were included. Average age at diagnosis was 59.7 years (range 14-83). 73.4% were male. Most studies did not document HPV status. Forty patients (85.1%) were p16 positive, and 34 (85.0%) were HPV-ISH positive. Overall survival was 75.4% at 1 year, and 40.0% at 2 years. Of patients with locoregional disease, 33.8% developed distant metastasis. 12.5% of patients developed locoregional recurrence. Patients who developed distant metastases had worse overall survival (p = 0.0004). No significant difference was found between treatment modalities. Human papilloma virus may be associated with oropharyngeal NEC. Current treatments provide locoregional control, but distant metastases are common and confer low overall survival.
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Affiliation(s)
- Michael H Froehlich
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michael C Shih
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lindsey Shehee
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Anvesh R Kompelli
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Otolaryngology - Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Alana Aylward
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - John M Kaczmar
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cherie Ann Nathan
- Department of Otolaryngology - Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Terry Day
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David M Neskey
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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10
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Narayen V, Shyam NDVN, Shravani R, Priyanka M. Small cell neuroendocrine carcinoma of buccal mucosa: Innocuous but invasive. J Oral Maxillofac Pathol 2022; 26:S91-S95. [PMID: 35450235 PMCID: PMC9017835 DOI: 10.4103/jomfp.jomfp_460_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022] Open
Abstract
Small cell neuroendocrine carcinoma (SNEC) was first described in the 19th century which is usually seen in association with lung cancer and is very rare in the oral cavity. Here, we report one such case in a 39-year-old male patient who presented with swelling on the left middle third of the face for 6 months. This is the 12th SNEC of oral cavity case so far reported in the English literature and the third case to be present on buccal mucosa. It presented as a nodular swelling over the buccal mucosa and was clinically diagnosed as a traumatic fibroma. The histopathological sections showed diffuse sheets of round cells with granular chromatin. Immunohistochemical findings helped us arrive at a final diagnosis. SNECs are highly proliferative tumors characterized by early and widespread metastases through the vascular channels. Hence, the diagnosis and appropriate management of these lesions is important to decrease the morbidity and mortality rate.
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Affiliation(s)
- Vaishali Narayen
- Department of Oral Pathology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - N D V N Shyam
- Department of Oral Pathology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Renukuntla Shravani
- Department of Oral Pathology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Mudududla Priyanka
- Department of Oral Pathology, Government Dental College and Hospital, Hyderabad, Telangana, India
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11
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Zhou YL, Peng YP, Liu QD, Chen XZ, He J, Wei W, Zhong GH, Zhang YQ, Liu Y, Pan JY, Feng SY, Liu ZG. Clinical Characteristics and Prognosis of Small Cell Carcinoma in the Nasopharynx: A Population-Based Study. Cancer Control 2022; 29:10732748221087075. [PMID: 35341342 PMCID: PMC8958697 DOI: 10.1177/10732748221087075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Nasopharyngeal small cell carcinoma (SmCC) is a rare histological type of nasopharyngeal cancer, and its prognosis remains poor. This study aimed to determine the clinical characteristics and survival prognostic factors of nasopharyngeal SmCC. Methods Detailed clinicopathologic and therapeutic characteristics of a patient diagnosed with nasopharyngeal SmCC were determined. Nasopharyngeal SmCC cases reported previously were reviewed and summarized. Furthermore, a retrospective analysis was performed on data from the Surveillance, Epidemiology, and End Results (SEER) Program database. Kaplan–Meier analysis was conducted to compare survival within groups. Univariate and multivariate analyses were performed to investigate prognostic factors. Results A nasopharyngeal SmCC patient treated with chemoradiotherapy who achieved 46 months long-term survival was reported. In reviewing 16 reported cases with epidemiologic and therapeutic details, we found most of nasopharyngeal SmCC patients were diagnosed with advanced grades and received chemoradiotherapy. In total, 13,993 cases of nasopharyngeal cancer were extracted from the SEER database, from which 57 nasopharyngeal SmCC cases were eventually screened out. The mean age of the patients was 55.70 years, and 64.9% of these cases were either grade III or IV; the median overall survival (OS) was 18 months. Statistically significant differences were observed in the OS values of groups categorized by age (P = .025) or radiotherapy (P = .037). Age (<70 years) and radiotherapy were identified as independent survival and prognostic factors. Conclusion Patients with nasopharyngeal SmCC are usually diagnosed with advanced grades and have poor prognoses; nevertheless, they can benefit from radiotherapy with prolonged overall survival.
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Affiliation(s)
- Yu-Ling Zhou
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ying-Peng Peng
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Qiao-Dan Liu
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Xian-Zhen Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Jianzhong He
- Department of Pathology, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Wei Wei
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Gui-Hua Zhong
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ya-Qin Zhang
- Department of Radiology, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ye Liu
- Department of Pathology, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Jia-Ying Pan
- Department of Otorhinolaryngology, Head and Neck Surgery, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Shao-Yan Feng
- Department of Otorhinolaryngology, Head and Neck Surgery, 477803The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Zhi-Gang Liu
- 477803The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, 477803Sun Yat-sen University, Zhuhai, Guangdong, China
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12
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Prantesh J, Dorth J, Asa SL, Mohamed A. Nasopharyngeal neuroendocrine neoplasms: Systematic review of the literature and case presentation. J Neuroendocrinol 2021; 33:e13005. [PMID: 34342078 DOI: 10.1111/jne.13005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/20/2021] [Accepted: 06/15/2021] [Indexed: 01/04/2023]
Abstract
Most of neuroendocrine neoplasms (NENs) are located in the gastrointestinal tract and lung, and they are rarely found on the upper aero-digestive tract, which limit the current literature about nasopharyngeal NENs. This systemic review will summarize the clinical, pathological features and optimal diagnosis and management of different types of nasopharyngeal NENs (NP NENs). In-addition, we herein report an EBV negative TP53-mutated/ Rb-wild type nasopharyngeal neuroendocrine carcinoma (NEC) in a young man in which touch preparation cytology studies were integral to establishing a definitive diagnosis. To our knowledge, only very few cases of primary neuroendocrine carcinoma of the nasopharynx have been reported in the literature and the reports of these cases have not included detailed description of different types and how to optimally diagnose and manage them. In this abstract, we also highlighted the evidence about the safety of using growth factors in patients with sickle cell anemia who are receiving cytotoxic chemotherapy.
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Affiliation(s)
- Jain Prantesh
- Department of Medicine, Division of Hematology and Medical Oncology, Seidman Cancer Center, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Jennifer Dorth
- Department of Radiation Oncology, Seidman Cancer Center, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Sylvia L Asa
- Department of Pathology, Seidman Cancer Center, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Amr Mohamed
- Department of Medicine, Division of Hematology and Medical Oncology, Seidman Cancer Center, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
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13
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Liu KY, Goldrich DY, Ninan SJ, Filimonov A, Lam H, Govindaraj S, Iloreta AM. The value of 68 Gallium-DOTATATE PET/CT in sinonasal neuroendocrine tumor management: A case series. Head Neck 2021; 43:E30-E40. [PMID: 33786927 DOI: 10.1002/hed.26695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND 68 Gallium-DOTATATE (68 Ga-DOTATATE) is a somatostatin analog used as a PET tracer to successfully identify neuroendocrine tumors (NETs). Due to the rarity of sinonasal NETs, there are few recommendations for 68 Ga-DOTATATE imaging in these patients. METHODS We discussed the impact of 68 Ga-DOTATATE imaging on the management of six sinonasal NET cases and reviewed existing literature. RESULTS 68 Ga-DOTATATE PET/CT revealed an unknown primary in one case and identified metastatic disease in a primary sinonasal small cell neuroendocrine carcinoma (SNEC) patient missed on conventional imaging. In two esthesioneuroblastoma (ENB) patients, 68 Ga-DOTATATE detected abnormal radiotracer uptake not present on 18F-FDG PET/CT and identified a patient for treatment with 177 Lu-DOTATATE. CONCLUSIONS This is the one of the first few reports, and the largest series to our knowledge, demonstrating the utility of 68 Ga-DOTATATE imaging for primary sinonasal SNEC and ENB. Further study is required to determine its role in sinonasal NET management.
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Affiliation(s)
- Katherine Y Liu
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David Y Goldrich
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sen J Ninan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrey Filimonov
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hansen Lam
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alfred Marc Iloreta
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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14
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Kaur J, Mogulla S, Malik A, Garg S. Unusual Presentation of a Sphenoidal Sinus Neuroendocrine Tumor: A Case Report and Review of Literature. Cureus 2021; 13:e13689. [PMID: 33833913 PMCID: PMC8019145 DOI: 10.7759/cureus.13689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Neuroendocrine tumors (NETs) have a heterogeneous pathology and indolent behavior, with the most common location being the gastrointestinal tract and then the lungs. The head and neck are rare sites of NET presentation with varied clinical signs and symptoms, which occasionally delay the diagnosis, thereby leading to an advanced stage at presentation. We present a rare case of paranasal sinus small cell neuroendocrine tumor and perform a review of the literature. A 71-year-old man presented with continuous bleeding from the left nostril and nasal congestion without any prior medical history. Clinical examination revealed nasal congestion, rhinorrhea, postnasal drip, and active bleeding. The laboratory data were within normal limits. Imaging studies showed a left sphenoid sinus mass extending to the left ethmoid sinus with a break in the cribriform plate encephalocele. An enlarged lymph node measuring 2.2 cm was noted in the left neck and supraclavicular region. The evaluation through stereotactic endoscopic sinus surgery and biopsy revealed left nasopharyngeal, sphenoid sinus, and ethmoid sinus masses. Pathologic biopsy findings were consistent with high-grade, malignant, small, round blue cell tumors. Immunohistochemical analysis confirmed high-grade small cell neuroendocrine carcinoma. The patient was diagnosed with stage IV (TXN2bM0, T: tumor size, N: lymph node, M: metastasis) high-grade neuroendocrine tumor of the left paranasal sinus. He was treated with concurrent chemoradiation therapy with two cycles of etoposide and cisplatin and radiation therapy with proton beam radiation therapy followed by two cycles of adjuvant etoposide cisplatin chemotherapy. The patient showed a good response to the treatment, as confirmed using imaging. He is currently being regularly followed up with serial imaging.
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Affiliation(s)
- Jasmeet Kaur
- Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, USA
| | - Swathi Mogulla
- Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, USA
| | - Ambreen Malik
- Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, USA
| | - Sandeep Garg
- Hematology and Medical Oncology, Saint Joseph Mercy Oakland Hospital, Pontiac, USA
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15
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Rare cases of head and neck's neuroendocrine carcinomas disease: Case series of 4 patients and review of the literature. Int J Surg Case Rep 2019; 66:270-276. [PMID: 31884263 PMCID: PMC6939065 DOI: 10.1016/j.ijscr.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/27/2019] [Accepted: 12/04/2019] [Indexed: 12/28/2022] Open
Abstract
Cervical lymph node SmCC as a primary tumor’s location, was never described in the literature according to what we know. AC neuroendocrine carcinoma of the tonsil has never been described in the literature up to our knowledge. A review of the literature was performed, indicating treatment and disease’s prognosis. In 2012, the 2005 WHO classification of neuroendocrine tumors of the head and neck region was modified by adding the ranges of the Ki-67 and suggested that LCNEC should be considered a distinct disease entity and be separated from AC.
Introduction Primary neuroendocrine carcinomas are uncommon head and neck malignancies. Their classification is still debated. We report four cases of unusual primary locations of neuroendocrine carcinomas of head and neck region emphasizing two entities and rare sites that were never described in the literature to the best of our knowledge. Presentation of cases We reported four different cases of neuroendocrine carcinomas (nasal cavity, larynx, lymph nodes and tonsil) treated in our institution. The diagnosis was made by biopsy and confirmed by Immunohistochemical study. We underscored 2 atypical and rare entities in their location and anatomo histopathological type. Chemotherapy and radiotherapy were proposed for patients with nasal’s and laryngeal locations. This latter had also undergone surgery. For lymph node location, the patient received decompressive radiotherapy alone. The patient diagnosed with neuroendocrine carcinoma of the tonsil didn’t get any treatment except initial tonsillectomy for diagnosis purposes. Regarding the evolution in our case series, 2 patients had a relapse with local and regional metastasis. Among the 4 patients, 50 % passed away, one is still alive with deterioration of his general status and one is lost to follow-up and refused undergoing further investigations. Discussion There is confusion in the literature regarding the classification of neuroendocrine carcinomas. According to the 2005 WHO, these lesions, can be subdivided into TC, AC (including LCNEC), SmCC, combined SmCC with nonsmall cell carcinoma, and paraganglioma. Their treatment is still debated. Through an overview of the literature, we have gathered the main studies and 2 meta-analysis summarizing the mainstay treatment and disease’s outcome. Conclusion Neuroendocrine carcinomas of head and neck region are aggressive tumors with poor prognosis, low incidence and their diagnosis is not obvious. The treatment protocol depends on the type, the site of the lesions, and metastasis status. It’s still not well codified.
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16
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Bacalao M, Beg MS, Cavuoti D, Zhu H, Sumer B, Myers L, Truelson J, Nedzi L, Sher D, Hughes R, Khan SA. Head and neck neuroendocrine tumors at a single institution over 15 years. Clin Case Rep 2019; 7:2508-2512. [PMID: 31893090 PMCID: PMC6935626 DOI: 10.1002/ccr3.2545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/12/2022] Open
Abstract
Head and neck cancer is a diverse group of rare diseases such as neuroendocrine tumors which can be thought of as extrapulmonary small-cell cancer. Surgery, chemotherapy, and radiation can frequently cure this disease, possibly due to early detection.
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Affiliation(s)
- Maria Bacalao
- Department of MedicineUT Southwestern Medical CenterDallasTexas
| | - Muhammad S. Beg
- Division of Hematology and Oncology/Harold C. Simmons Comprehensive Cancer CenterUT Southwestern Medical CenterDallasTexas
| | - Dominick Cavuoti
- Department of PathologyUT Southwestern Medical CenterDallasTexas
| | - Hong Zhu
- Department of Clinical SciencesUT Southwestern Medical CenterDallasTexas
| | - Baran Sumer
- Department of OtolaryngologyUT Southwestern Medical CenterDallasTexas
| | - Larry Myers
- Department of OtolaryngologyUT Southwestern Medical CenterDallasTexas
| | - John Truelson
- Department of OtolaryngologyUT Southwestern Medical CenterDallasTexas
| | - Lucien Nedzi
- Department of Radiation OncologyUT Southwestern Medical CenterDallasTexas
| | - David Sher
- Department of Radiation OncologyUT Southwestern Medical CenterDallasTexas
| | - Randall Hughes
- Division of Hematology and Oncology/Harold C. Simmons Comprehensive Cancer CenterUT Southwestern Medical CenterDallasTexas
| | - Saad A. Khan
- Division of Hematology and Oncology/Harold C. Simmons Comprehensive Cancer CenterUT Southwestern Medical CenterDallasTexas
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17
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Bean MB, Liu Y, Jiang R, Steuer CE, Patel M, McDonald MW, Higgins KA, Beitler JJ, Shin DM, Saba NF. Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data. Oncologist 2019; 24:1562-1569. [PMID: 31391295 DOI: 10.1634/theoncologist.2018-0054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/06/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Small cell carcinomas of the head and neck (SmCCHNs) are rare neoplasms with an unfavorable prognosis. Population-based data describing survival and prognostic factors for SmCCHN are limited. METHODS Data were obtained from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database for 1973-2013. Patient and tumor-related characteristics for SmCCHN were compared with those for squamous cell carcinoma of the head and neck (SCCHN). Survival was compared by constructing Kaplan-Meier curves and Cox proportional hazard models with and without propensity score matching. RESULTS The data set included 609 SmCCHN and 227,943 SCCHN cases. Both histological subtypes were more common in men than women and more common in white patients. SmCCHN was most likely to originate in the larynx, glottis and hypopharynx, or salivary glands and to present with more advanced stage and grade. SCCHN was most likely to originate in the oral cavity and was found infrequently in the salivary glands. Overall 5- and 10-year survival estimates were 27% and 18% for SmCCHN and 46% and 31% for SCCHN, respectively. In multivariable survival analyses adjusting for age, sex, race, marital status, year of diagnosis, stage, grade, and receipt of radiation, the hazard ratio (HR) comparing SmCCHN with SCCHN was 1.53 with a 95% confidence interval (CI) from 1.39 to 1.68. Average 5-year survival varied widely between the histologic types when comparing tumor sites: 14.5% for SmCCHN versus 48.9% for SCCHN in the oropharynx. In propensity score matched analyses, the corresponding HR was 1.27 (95% CI, 1.15-1.40). CONCLUSION Compared with SCCHN, SmCCHN carries a worse survival and is more likely to present with more advanced stage. IMPLICATIONS FOR PRACTICE Small cell carcinoma of the head and neck (SmCCHN) is a rare subtype of head and neck cancer. In this Surveillance, Epidemiology, and End Results (SEER) data analysis, the characteristics and survival of SmCCHN are compared with those of the common squamous cell carcinoma of the head and neck. Results show that SmCCHN carries a worse prognosis and tends to present at a more advanced stage; SmCCHN also is ten times more likely to originate from the salivary glands. These findings may have implications for clinical practice, as location of the tumor may strongly associate with the pathologic diagnosis. If a SmCCHN is diagnosed, a disseminated disease is likely; hence vigilance in staging procedures is indicated.
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Affiliation(s)
- Marta B Bean
- Emory School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Yuan Liu
- Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Renjain Jiang
- Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Conor Ernst Steuer
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Mihir Patel
- Department of Otolaryngology, Emory University, Atlanta, Georgia, USA
| | | | | | | | - Dong Moon Shin
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
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18
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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
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19
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Sen R, Bhutani N, Saini R, Jashanpreet. 'Primary small cell carcinoma of tonsil: An extreme rarity.'. Ann Med Surg (Lond) 2019; 44:29-32. [PMID: 31297193 PMCID: PMC6598600 DOI: 10.1016/j.amsu.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/24/2019] [Accepted: 06/19/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction Small cell neuroendocrine carcinoma (NEC) that originates in the tonsil is extremely rare and carries a poor prognosis. Only a few cases of this tumor have been reported so far and the standard treatment protocol remains uncertain. Case report Here, we describe a 65-year-old woman presenting with throat pain. Computed tomography (CT) scan revealed a mass with moderate enhancement in the right tonsil. A biopsy of the tonsillar mass was performed and histologic examination revealed small round to oval tumor cells arranged in cords or nests, containing hyperchromatic nuclei and scant cytoplasm. Mitotic figures were readily identified. Immunohistochemical staining further corroborated the diagnosis. A diagnosis of primary small cell NEC of the left tonsil was rendered. The patient was treated by six cycles of cisplatin combined with etoposide and the masses showed initial complete response. We also provide a succinct review of all tonsillar SCC cases reported in the English literature and their outcomes. Conclusion Small Cell Carcinoma of the tonsil is an extremely rare entity with an aggressive disease course and poor prognosis. Therefore, it is important for the clinicians to be aware of the uncommon occurrence of this disease and its management. Small cell NECs of the tonsil are extremely rare and only a few cases were added since it was firstly repoted. The cell of origin was initially thought to be from amine-precursor uptake and decarboxylase (APUD or Kulchitsky) cells; however, the current opinion favors their origin from multipotential stem cells. Thus far, the therapeutic strategy has not been properly formulated due to the paucity of data.
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Affiliation(s)
- Rajeev Sen
- Deptt. of Pathology, PGIMS Rohtak, Haryana, India
| | | | - Reeti Saini
- Deptt. of Pathology, PGIMS Rohtak, Haryana, India
| | - Jashanpreet
- Deptt. of Pathology, PGIMS Rohtak, Haryana, India
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20
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Pollock SE, Yousef M, Pallavi R, Pollock J. Cutaneous basal cell carcinoma mimicking small cell carcinoma. Clin Case Rep 2019; 7:1276-1279. [PMID: 31360466 PMCID: PMC6637456 DOI: 10.1002/ccr3.2133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/15/2019] [Accepted: 02/20/2019] [Indexed: 12/18/2022] Open
Abstract
Neuroendocrine differentiation seen in basal cell carcinomas (BCC) is not generally appreciated by oncologists and can introduce a component of confusion when diagnosing a tumor and developing a management plan. Understanding that BCC commonly have this feature can assist the treating oncologist.
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Affiliation(s)
- Samara E. Pollock
- Office of Medical Student EducationBoston University School of MedicineBostonMassachusetts
| | - Michael Yousef
- Faculty Attending, Department of PathologyWheeling HospitalWheelingWest Virginia
| | - Ranjita Pallavi
- Faculty Attending, Division of Medical Oncology, The Schiffler Cancer CenterWheeling HospitalWheelingWest Virginia
| | - Jondavid Pollock
- Division of Radiation Oncology, The Schiffler Cancer CenterWheeling HospitalWheelingWest Virginia
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21
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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.
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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
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22
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Fatima H, Awan K, Mahmood H, Arif S, Faheem M. Primary small-cell carcinoma of the glottic larynx: A case report from Northern Pakistan. JOURNAL OF CANCER RESEARCH AND PRACTICE 2019. [DOI: 10.4103/jcrp.jcrp_2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Sinonasal inverted papilloma associated with small cell neuroendocrine carcinoma: A case report and literature review of rare malignancies associated with inverted papilloma. Auris Nasus Larynx 2018; 46:641-650. [PMID: 30545727 DOI: 10.1016/j.anl.2018.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 12/29/2022]
Abstract
We report a rare case of sinonasal inverted papilloma (IP) associated with small cell neuroendocrine carcinoma (SNEC). To our knowledge, this is the first report to describe SNEC found during the treatment of sinonasal IP. Surgery and five cycles of cisplatin plus etoposide with concurrent intensity modulated radiation therapy were performed. Neither local recurrence nor distant metastasis was noted during 6 years of post-diagnostic follow-up. The prognosis of SNEC is very poor. Treatment planning for sinonasal IP should consider a possible association with this rare but aggressive malignancy, whose treatment is completely different from that of squamous cell carcinoma, a malignancy which is commonly associated with IP. We also performed a PubMed review of the literature to identify the incidence and pathological diagnosis of associated malignancy. Among a total of 5286 cases of sinonasal IP (61 studies), the incidence of associated malignancy was 8.02% in squamous cell carcinoma, 0.19% in transitional cell carcinoma, 0.04% in mucoepidermoid carcinoma, 0.02% in verrucous cell carcinoma and 0.02% in adenocarcinoma. The incidence of associated malignancy was significantly higher in East and Southeast Asia (11.0%) and North America (10.4%) than in Europe (3.9%) (p=0.04 and p=0.03, respectively; T-test).
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24
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Natarajan A, Abugroun A, Khan A, Jahangir N. The First Report of Small Cell Cancer of the Uvula Presenting With Ectopic Adrenocorticotropic Hormone Syndrome. World J Oncol 2018; 9:115-118. [PMID: 30220949 PMCID: PMC6134991 DOI: 10.14740/wjon1130w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/10/2018] [Indexed: 11/11/2022] Open
Abstract
Small cell carcinoma (SmCC) of the head and neck is a rare occurrence. We herein present a case of a 62-year-old female who was diagnosed with small cell cancer of the uvula. The patient developed increased body swelling, elevated blood pressure, persistent hypokalemia and new onset diabetes mellitus. Further workup confirmed a diagnosis of Cushing's syndrome secondary to ectopic adrenocorticotropic hormone (ACTH) production. To our knowledge, this is only the second case of SmCC of the uvula described in literature, and the first associated with any paraneoplastic syndrome. By reporting this case, we aim to characterize the tumor clinical course and highlight the aggressive nature of its growth.
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Affiliation(s)
- Arjun Natarajan
- Department of Internal Medicine, Advocate Illinois Masonic Medical Centre, Chicago, IL, USA
| | - Ashraf Abugroun
- Department of Internal Medicine, Advocate Illinois Masonic Medical Centre, Chicago, IL, USA
| | - Amir Khan
- Department of Internal Medicine, Advocate Illinois Masonic Medical Centre, Chicago, IL, USA
| | - Numan Jahangir
- Department of Internal Medicine, Advocate Illinois Masonic Medical Centre, Chicago, IL, USA
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Wang X, Chen Q, Meng J. Successful cisplatin-etoposide chemotherapy-based treatment of a primary small cell neuroendocrine carcinoma of the tonsil with multiple metastases: a case report. Onco Targets Ther 2018; 11:5391-5395. [PMID: 30214244 PMCID: PMC6128267 DOI: 10.2147/ott.s173231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Extrapulmonary small cell neuroendocrine carcinoma (SNEC) is an extremely rare and highly malignant tumor with a poor prognosis. Multiple metastases of SNEC are even more rare, and patients with locally advanced and metastatic disease generally face a poor outcome. To date, only a few cases of SNEC have been reported. Here, we describe a rare case of a 70-year-old female patient with SNEC of the tonsil who presented with multiple metastases and had achieved a complete response (CR) of the primary lesion and cervical lymph nodes for more than 1 year after receiving palliative chemotherapy. Initially, the patient presented with a 2-month history of throat pain. Magnetic resonance imaging and computed tomography revealed a soft mass with moderate enhancement on the left tonsil, which was confirmed by incisional aspiration biopsy. She was additionally sent for a positron emission tomography scan to evaluate small metastases in the left cervical lymph node, right lung, multiple mediastinal lymph nodes, and the fourth lumbar (L4) vertebra body metastases. Histopathological examination of the SNEC confirmed a nested, typical endocrine appearance with small round cells containing ovoid-shaped nuclei and high mitotic activity. Immunohistochemically, the tumor cells were positive for cytokeratin 8/18+, synaptophysin+, CD56+, and Ki-67 (<50%). The patient received 6 cycles of cisplatin combined with etoposide and was subsequently placed under close observation (<12 months). To date, she has achieved a CR of the primary lesion and cervical lymph nodes. In summary, we have described a case of successful treatment after chemotherapy for SNEC and have elucidated professional knowledge regarding the relevant aspects of SNEC.
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Affiliation(s)
- Xing Wang
- Department of Oromaxillofacial-Head and Neck Surgery, Affiliated Xuzhou Hospital, College of Medicine, Southeast University, Xuzhou, People's Republic of China, .,Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China
| | - Qiming Chen
- Department of Oromaxillofacial-Head and Neck Surgery, Affiliated Xuzhou Hospital, College of Medicine, Southeast University, Xuzhou, People's Republic of China,
| | - Jian Meng
- Department of Oromaxillofacial-Head and Neck Surgery, Affiliated Xuzhou Hospital, College of Medicine, Southeast University, Xuzhou, People's Republic of China,
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Ho WJ, Rooper L, Sagorsky S, Kang H. A robust response to combination immune checkpoint inhibitor therapy in HPV-related small cell cancer: a case report. J Immunother Cancer 2018; 6:33. [PMID: 29743117 PMCID: PMC5943998 DOI: 10.1186/s40425-018-0348-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/29/2018] [Indexed: 02/01/2023] Open
Abstract
Background Human papillomavirus-related small cell carcinoma of the head and neck is an extremely rare, aggressive subtype with poor outcomes. Therapeutic options are limited and are largely adopted from small cell lung cancer treatment paradigms. Case presentation This report describes a 69-year old male who was diagnosed of HPV-related oropharyngeal cancer with mixed small cell and squamous cell pathology which was clinically aggressive and progressed through multimodal platinum-based therapies. Upon manifestation of worsening metastatic disease, the patient was initiated on a combination of ipilimumab and nivolumab. Within 2 months of starting immunotherapy, a robust partial response was observed. During the treatment course, the patient developed immune-related adverse effects including new diabetes mellitus, colitis, and hypothyroidism. The disease-specific survival was 26 months. Conclusion Combination immunotherapy may be an attractive option for HPV-related small cell head and neck cancers resistant to other treatment modalities and thus warrants further evaluation. Electronic supplementary material The online version of this article (10.1186/s40425-018-0348-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Won Jin Ho
- Department of Oncology, Johns Hopkins University School of Medicine, 1650 Orleans St, CRB1 Rm#186, Baltimore, MD, 21287, USA
| | - Lisa Rooper
- Department of Pathology, Johns Hopkins University School of Medicine, 410 N Broadway, Rm#2249, Baltimore, MD, 21287, USA
| | - Sarah Sagorsky
- Department of Oncology, Johns Hopkins University School of Medicine, 1650 Orleans St, CRB1 G86, Baltimore, MD, 21287, USA
| | - Hyunseok Kang
- Department of Oncology, Johns Hopkins University School of Medicine, 1550 Orleans St, CRB2 5m44, Baltimore, MD, 21287, USA.
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Small Cell Neuroendocrine Carcinoma: A Rare Nasopharyngeal Malignancy with Aggressive Clinical Course. Indian J Otolaryngol Head Neck Surg 2018; 70:454-458. [PMID: 30211108 DOI: 10.1007/s12070-018-1344-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 04/04/2018] [Indexed: 02/07/2023] Open
Abstract
Primary small cell neuroendocrine carcinoma is uncommon in head and neck region, with occasional cases in nasopharynx. Distinction from other round cell tumors is imperative to ensure optimal patient management. We present a case of a 30-year-old woman who presented with a rapidly growing nasopharyngeal mass.
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Human Papillomavirus-Related Neuroendocrine Carcinomas of the Head and Neck. Head Neck Pathol 2018; 12:9-12. [PMID: 29556964 PMCID: PMC5873494 DOI: 10.1007/s12105-018-0886-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/03/2018] [Indexed: 11/27/2022]
Abstract
Human papillomavirus (HPV)-related head and neck carcinoma (HNC) represents an important subgroup of head and neck cancer that is characterized by a consistent microscopic appearance and a favorable prognosis. A growing experience with HPV testing, however, has uncovered variants that deviate from the prototypic HPV-HNC with respect to morphology. While these HPV-HNCs may deviate morphologically from the prototype, they do not appear to stray far from the favorable clinical outcome assigned to HPV-positive status. In effect, HPV positivity trumps traditional prognostic features predicated on morphology such as tumor grade and histologic subtype when it comes to predicting clinical behavior. For the diagnostic pathologist, the pedestrian task of tumor grading and subtyping would seem to be of little prognostic or therapeutic relevance when it comes to HPV-HNC. Recognition and documentation of neuroendocrine differentiation is a most notable exception. Forms of HPV-HNC have now been reported that morphologically resemble small cell carcinoma (SCC) and large cell neuroendocrine carcinoma (LCNEC) of other sites, and that immunohistochemically exhibit neuroendocrine differentiation. Despite the presence of HPV, these SCCs and LCNECs share the same aggressive clinical behavior of their counterparts in the lung and other sites where the high grade neuroendocrine phenotype is associated with early distant spread and poor overall survival. Consequently, the high grade neuroendocrine phenotype should be regarded as an aggressive form of HPV-HNC where tumor morphology displaces HPV positivity as the most important prognostic feature.
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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.
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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.
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Pytal M, Olejniczak I, Kupnicki P, Trenda-Lewy I, Michalecki Ł. The small cell carcinoma neuroendocrine type of the larynx—Case report. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.poamed.2016.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kuan EC, Alonso JE, Tajudeen BA, Arshi A, Mallen-St Clair J, St John MA. Small cell carcinoma of the head and neck: A comparative study by primary site based on population data. Laryngoscope 2016; 127:1785-1790. [PMID: 27859290 DOI: 10.1002/lary.26406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 09/07/2016] [Accepted: 10/07/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Small cell carcinoma (SmCC) of the head and neck is an extremely rare neuroendocrine malignancy. In this study, we describe the incidence and determinants of survival of patients with SmCC of the head and neck between the years of 1973 and 2012 using the Surveillance, Epidemiology, and End Results database as differed by primary site. STUDY DESIGN Retrospective, population-based cohort study. METHODS A total of 237 cases of SmCC of the head and neck were identified, which was divided into sinonasal primaries (n = 82) and all other head and neck primaries (n = 155). Clinicopathologic and epidemiologic variables were analyzed as predictors of overall survival (OS) and disease-specific survival (DSS) based on the Kaplan-Meier method. RESULTS More than half of sinonasal primaries presented with Kadish stage C or D. On multivariate analysis, surgery was the only independent predictor of improved DSS (P = .008) for sinonasal primaries; in contrast, radiation therapy was a favorable prognosticator for OS (P = .007) and DSS (P = .043) in extrasinonasal sites. Comparison of survival between sinonasal primaries and all other sites demonstrated that sinonasal SmCC had uniformly better OS (P = .002) and DSS (P = .006). CONCLUSIONS SmCC in the head and neck remains rare, and sinonasal primaries appear to have improved survival compared to other sites. Based on these results, optimal treatment for sinonasal SmCC appears to be surgical therapy, whereas radiation therapy is the preferred treatment for SmCC of other primary sites, particularly the larynx. LEVEL OF EVIDENCE 4. Laryngoscope, 127:1785-1790, 2017.
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Affiliation(s)
- Edward C Kuan
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Jose E Alonso
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Bobby A Tajudeen
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Armin Arshi
- Department of Orthopaedic Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Jon Mallen-St Clair
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco Medical Center, San Francisco, California, U.S.A
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, U.S.A.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles Medical Center, Los Angeles, California, U.S.A.,University of California, Los Angeles Head and Neck Cancer Program, University of California, Los Angeles Medical Center, Los Angeles, California, U.S.A
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van der Laan TP, Iepsma R, Witjes MJH, van der Laan BFAM, Plaat BEC, Halmos GB. Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma: The importance of differentiation grade in determining treatment strategy. Oral Oncol 2016; 63:1-9. [PMID: 27938993 DOI: 10.1016/j.oraloncology.2016.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 09/19/2016] [Accepted: 10/02/2016] [Indexed: 12/27/2022]
Abstract
The aim of this meta-analysis was to provide treatment guidelines for sinonasal neuroendocrine carcinoma (SNC) by combining all available data in the literature. A literature search for all studies concerning SNC was performed against the MEDLINE and EMBASE databases. Available clinical data was normalized, pooled, and statistically analyzed. A total of 701 cases of SNC were available for analysis, comprising 127 well or moderately differentiated sinonasal neuroendocrine carcinomas (SNEC), 459 sinonasal undifferentiated carcinoma (SNUC) and 115 sinonasal small cell carcinoma (SmCC). Tumor type was the most important predictor of survival, with a 5-year disease-specific survival (DSS) of 70.2% for SNEC, 35.9% for SNUC and 46.1% for SmCC. Tumor stage on presentation was of limited value in predicting survival or response to treatment. Overall, the application of surgery yielded significantly better results (5-year DSS 52.2% versus 30.1%, p<0.001). In SNUC, radiotherapy was a beneficial supplement to surgery (5-year DSS 54.7% versus 15.7%, p=0.027), while radiotherapy as monotherapy performed poorly (5-year DSS 17.9%). Chemotherapy did not appear to contribute to survival. Based on these findings, we can conclude that the most important predictors of survival in SNC are differentiation grade and the associated choice of treatment modality. In contrast to other head and neck cancers, tumor staging appears of limited value in predicting survival or deciding on a treatment strategy. Surgery should be the cornerstone of treatment, supplemented by radiotherapy in poorly differentiated subtypes (SNUC, SmCC). Chemotherapy does not appear to contribute to survival.
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Affiliation(s)
- Tom P van der Laan
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands; University of Groningen, Graduate School of Medical Sciences (Damage and Repair in Cancer Development and Cancer Treatment), The Netherlands
| | - René Iepsma
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands
| | - Max J H Witjes
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, The Netherlands
| | - Bernard F A M van der Laan
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands; University of Groningen, Graduate School of Medical Sciences (Damage and Repair in Cancer Development and Cancer Treatment), The Netherlands
| | - Boudewijn E C Plaat
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands
| | - Gyorgy B Halmos
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands.
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Nakano T, Motoshita J, Tanaka R, Okabe M, Tamae A, Shiratsuchi H, Yasumatsu R, Nakashima T, Nakagawa T. Primary combined small cell carcinoma and squamous cell carcinoma of the oropharynx with special reference to EGFR status of small cell carcinoma component: Case report and review of the literature. Auris Nasus Larynx 2016; 44:472-478. [PMID: 27496009 DOI: 10.1016/j.anl.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/12/2016] [Accepted: 07/19/2016] [Indexed: 12/24/2022]
Abstract
Combined small cell carcinoma (SCC) and squamous cell carcinoma (SqCC) of the oropharynx is extremely rare and shows an aggressive clinical course. There are only 5 reported cases of combined SCC and SqCC in the English language literature. Here, we report a 59-year-old male presenting with a right tonsillar mass. The mass was biopsied, and the histological findings showed a proliferation of small-sized tumor cells with scant cytoplasm. Immunohistochemically, the tumor cells were positive for neuroendocrine markers (synaptophysin, chromogranin A, and CD56). Our first diagnosis was tonsillar small cell carcinoma. We treated the patient with concurrent chemoradiotherapy together with cisplatin followed by surgery. The resected tonsillar specimen showed a residual tumor composed of SCC and SqCC, and lymph nodes showed metastatic tumor cells of the SCC component. Immunohistochemically, the SCC component was positive for all neuroendocrine markers and p16; on the other hand, the SqCC component was positive for p40, p63, p16, and EGFR. Fluorescence in situ hybridization revealed that neither component showed any EGFR gene copy number gain. The patient was treated with adjuvant chemotherapy consisting of irinotecan and cisplatin. Liver and bone metastases developed, resulting in the death of the patient. We discuss the present case and review similar cases. Most cases of combined SCC and SqCC occur regardless of p16 status, and a therapeutic strategy has yet to be determined. Further examination of this kind of combined tumor is necessary.
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Affiliation(s)
- Takafumi Nakano
- Department of Otolaryngology, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan; Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
| | - Junichi Motoshita
- Department of Pathology, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan
| | - Risa Tanaka
- Department of Internal Medicine, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan
| | - Midori Okabe
- Department of Otolaryngology, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan
| | - Akihiro Tamae
- Department of Otolaryngology, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan
| | - Hideki Shiratsuchi
- Department of Otolaryngology, Hamanomachi Hospital, Nagahama 3-3-1, Chuo-ku, Fukuoka 810-8539, Japan
| | - Ryuji Yasumatsu
- Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Torahiko Nakashima
- Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Takashi Nakagawa
- Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Zhan KY, Din HA, Muus JS, Nguyen SA, Lentsch EJ. Predictors of survival in parotid small cell carcinoma: A study of 344 cases. Laryngoscope 2016; 126:2036-40. [PMID: 26972357 DOI: 10.1002/lary.25923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/04/2016] [Accepted: 01/21/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS We sought to better characterize patient, tumor, and long-term survival characteristics of parotid small cell carcinoma (SmCC) with the National Cancer Database (NCDB). STUDY DESIGN Retrospective database review. METHODS We reviewed the NCDB (1998-2012) for all cases of parotid SmCC. Relevant demographic, tumor, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognosticators. RESULTS Out of 30,813 parotid gland cancers in the NCDB, we found 344 cases of parotid SmCC (1.11%). Age at diagnosis ranged from 23 to 91 years (mean = 73 years). Most patients (73.0%) were male. Most tumors were 2 to 4 cm in size (51.4%). Regional metastases were common (50.8% cN+ and 65.1% pN+) and distant metastasis (7.3%) was uncommon. Occult nodes were found in 14.4% of cases. Overall survival at 5 and 10 years was 37% and 20%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, age (hazard ratio [HR]: 1.05, 95% confidence interval [CI]: 1.03-1.08, P < .001), tumor size of 2 to 4 cm (HR: 2.51, 95% CI: 1.83-5.11, P = .011), tumors >4 cm (HR: 3.44, 95% CI: 1.63-7.27) and distant metastasis (HR: 2.06, 95% CI: 1.02-4.14, P = .043) remained significant prognosticators in our multivariate model. Nodal disease was not a significant risk factor after adjustment (P = .055). CONCLUSIONS SmCC is a rare parotid malignancy with a poor prognosis. Regional metastases were common, whereas distant metastases were uncommon. Elective neck treatment should be considered due to the incidence of occult nodal disease. LEVEL OF EVIDENCE 4 Laryngoscope, 126:2036-2040, 2016.
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Affiliation(s)
- Kevin Y Zhan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Hassieb A Din
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - John S Muus
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Shaun A Nguyen
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Eric J Lentsch
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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Rivero A, Liang J. Sinonasal small cell neuroendocrine carcinoma: a systematic review of 80 patients. Int Forum Allergy Rhinol 2016; 6:744-51. [PMID: 26880574 DOI: 10.1002/alr.21734] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 11/27/2015] [Accepted: 12/31/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The objective of this study was to review the published literature related to sinonasal small cell neuroendocrine carcinomas (SCNECs). Clinical presentation, demographics, treatment, and outcomes of this uncommon disease are reported. METHODS A systematic review of studies for sinonasal SCNECs in PubMed and Ovid databases from 1970 to 2014 was conducted. Bibliographies of selected articles were also examined. Articles were examined for patient data that reported disease outcome. RESULTS Thirty-four articles were included in this analysis, comprising a total of 80 cases. The mean age of presentation was 53.0 years. Nasal obstruction (53.8%) and epistaxis (48.8%) were the most common presenting symptoms. The nasal cavity and septum (32.5%) was the most common site of involvement. Seventy percent of patients presented with American Joint Committee on Cancer (AJCC) stage IV disease. Combination chemotherapy and radiation therapy was the most common treatment modality, used in 21 cases (26.3%). The second and third most common treatment modalities was combination surgery and chemoradiation therapy (21.3%), and surgery alone (18.8%), respectively. A total of 37 patients (46.3%) were alive after a mean follow-up of 30.8 months (median 15.5 months), independent of treatment modality. Of the treatment modalities, multimodality therapy remained the most common therapy. CONCLUSION This review contains the largest pool of sinonasal SCNEC patients to date. Sinonasal SCNEC is a rare and aggressive neoplasm, and there is currently no standard of care for treatment. Various treatment modalities have been employed. Our systematic review suggests that multimodality therapy remains the most common treatment of sinonasal SCNEC.
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Villarreal IM, Arellano B, Pinilla M, Tejerina E, López-Cortijo C. Small-cell neuroendocrine carcinoma of the nasal septum: unusual location for a known type of neoplasm. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2016. [DOI: 10.1080/23772484.2016.1225501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Coca-Pelaz A, Devaney KO, Rodrigo JP, Halmos GB, Strojan P, Mendenhall WM, Eisbruch A, Smee R, Kusafuka K, Rinaldo A, Ferlito A. Should patients with laryngeal small cell neuroendocrine carcinoma receive prophylactic cranial irradiation? Eur Arch Otorhinolaryngol 2015; 273:2925-30. [DOI: 10.1007/s00405-015-3799-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/12/2015] [Indexed: 12/23/2022]
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De Felice F, Lei M, Guerrero Urbano T. Controversies in small cell carcinoma of the head and neck: Prophylactic cranial irradiation (PCI) after primary complete initial remission. Cancer Treat Rev 2015. [PMID: 26211602 DOI: 10.1016/j.ctrv.2015.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Small cell carcinoma of head and neck region (SmCCHN) represents a rare entity and its management remains a significant clinical challenge. Complete initial response to primary therapy poses a difficult and controversial scenario for radiation oncologists. Prophylactic cranial irradiation (PCI) has long been established in the management of small cell lung cancer; however, its role in SmCCHN is still called into question. The rationale behind PCI lies in the eradication of possible micro-metastatic brain disease, which is often documented in this type of cancer. No randomized trials on this topic are available. This review, based on 20 retrospective studies, addresses the controversies in the use of PCI in SmCCHN management.
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Affiliation(s)
- Francesca De Felice
- Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK; Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - Mary Lei
- Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
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Small cell neuroendocrine carcinoma of larynx: case series and literature review. The Journal of Laryngology & Otology 2015; 129:910-5. [DOI: 10.1017/s0022215115001668] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [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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[Epithelial neuroendocrine tumors of the upper respiratory tract: New entities, new perspectives]. DER PATHOLOGE 2015; 36:271-7. [PMID: 25963713 DOI: 10.1007/s00292-015-0031-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Epithelial neuroendocrine tumors of the upper respiratory tract are rare and are classified as typical and atypical carcinoid versus small cell neuroendocrine carcinoma. Furthermore, a giant cell variant of neuroendocrine carcinoma is suggested corresponding to the bronchopulmonary system as well as a recently described subtype of oropharyngeal small cell neuroendocrine carcinoma associated with human papillomavirus. Many arguments relying on clinical as well as on molecular findings indicate that the distinction between carcinoid and poorly differentiated neuroendocrine carcinoma does not only reflect different degrees of differentiation of otherwise related tumors but indicates the existence of substantially different types of neoplasms.
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Takahashi S, Miyashita T, Hoshikawa H, Haba R, Togami T, Shibata T. Accelerated hyperfractionated radiotherapy for small cell carcinoma of the nasopharynx. Head Neck 2015; 37:E63-5. [DOI: 10.1002/hed.23888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/23/2014] [Accepted: 09/27/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Shigeo Takahashi
- Department of Radiation Oncology; Kagawa University Hospital; Kagawa Japan
| | - Takenori Miyashita
- Department of Otolaryngology; Head and Neck Surgery, Kagawa University Hospital; Kagawa Japan
| | - Hiroshi Hoshikawa
- Department of Otolaryngology; Head and Neck Surgery, Kagawa University Hospital; Kagawa Japan
| | - Reiji Haba
- Department of Diagnostic Pathology; Kagawa University Hospital; Kagawa Japan
| | - Taro Togami
- Department of Radiation Oncology; Kagawa University Hospital; Kagawa Japan
| | - Toru Shibata
- Department of Radiation Oncology; Kagawa University Hospital; Kagawa Japan
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Extrapulmonary small cell carcinoma: the University of Kansas experience and review of literature. Med Oncol 2014; 31:187. [PMID: 25151532 DOI: 10.1007/s12032-014-0187-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/13/2014] [Indexed: 01/12/2023]
Abstract
Though extrapulmonary small cell carcinoma was first described over 80 years ago, definitive treatment recommendations are lacking. The treatment strategies commonly utilized are extrapolated from pulmonary small cell carcinoma experience. A better understanding of this entity is needed to improve management approach. The University of Kansas tumor registry was reviewed from 1990 to 2013. Thirty-five cases met the inclusion and exclusion criteria for review. Age, gender, smoking status, weight loss, metastatic disease-related data, stage, performance status (PS), treatment received, and survival data were collected. Patients were evaluated with a variety of primary locations of disease including GI tract (29%), GU tract (35%), Gyn organs (17%), head and neck (14%), and unknown primary (9%). Several sites of metastatic disease were noted, with 57 and 43% of patients meeting criteria for limited disease (LD) and extensive disease (ED), respectively. Chemotherapy, surgery, and radiation were used in several different regimens, with small cell lung cancer-type regimens incorporating a platinum and etoposide being the most common (74%). Patients with LD had a median survival of 36 months compared with 5 months in patients with ED (p<0.0001). Among different primary sites, patients with GU and Gyn LD tumors had best median survival of 36 months. Among other variables that were examined with respect to their poor prognostic significance, PS>2 (p=0.001) and one or fewer number of treatment modalities especially in LD (p=0.0005) were found to be associated significantly with mortality. GI and GU tract tumors were the most common primary sites of disease in our retrospective review. Survival varied according to stage, PS, site of primary disease, use of chemotherapy, and number of treatment modalities used. Further studies are needed to better understand this rare disorder and optimize management approach.
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Singla A, Singla A, Gallagher R. A rare case and literature review of primary neuroendocrine carcinoma of the tongue†. J Surg Case Rep 2014; 2014:rju084. [PMID: 25148834 PMCID: PMC4141286 DOI: 10.1093/jscr/rju084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Neuroendocrine tumours are rare and have been reported to arise in a number of structures within the head and neck. We present the case of a 55-year-old lady who presented a T1-N2-M0 neuroendocrine tumour of the tongue and right level 2A lymphadenopathy. The patient underwent a partial right-sided glossectomy and a modified radical neck dissection. Given the rarity of small cell neuroendocrine tumours of the tongue, there is some ambiguity with respect to classification. Treatment for neuroendocrine tumours is most effective with a multimodality approach and a poor response to chemotherapy is an important prognostic indicator. Radiotherapy, combined with chemotherapy, has shown the most promise with complete resolution of the primary tumour and metastatic disease. Due to the rarity of neuroendocrine tumours and the lack of favourable prognostic indicators, defining optimal treatment remains difficult. As a result, they continue to have a poor overall prognosis.
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Bishop JA. Non-squamous variants of human papillomavirus-related head and neck carcinoma. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.mpdhp.2014.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Abstract
A 40-year-old man presented with a painless enlarging right neck mass over several weeks without a history of trauma or infection. Ultrasound, contrast-enhanced CT, and MRI showed a mass in an expanded vein extending into the parotid gland. Blood-stained fine-needle aspiration biopsy demonstrated atypical lymphoid cells, but there was insufficient material for a diagnosis. The mass was intensely avid on 18F-FDG PET/CT and was suggestive of a neoplasm. Excision confirmed a mass within the external jugular vein with areas of invasion through the vessel wall. A diagnosis of small cell neuroendocrine carcinoma was made on histology.
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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: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [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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Liu M, Zhong M, Sun C. Primary neuroendocrine small cell carcinoma of the parotid gland: A case report and review of the literature. Oncol Lett 2014; 8:1275-1278. [PMID: 25120705 PMCID: PMC4114714 DOI: 10.3892/ol.2014.2258] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 05/29/2014] [Indexed: 12/27/2022] Open
Abstract
Small cell carcinoma (SCC) is a malignant epithelial tumor that predominantly arises in the lungs. Primary SCC of the parotid gland is rare and difficult to diagnose by analysis of frozen sections obtained during surgery. Due to the aggressive nature of SCC and the frequent occurrence of distant metastases, identification of the disease is important. The current study reports the case of a male patient who presented with a right parotid gland mass. The tumor was resected and evaluated by light microscopy and immunohistochemical analysis. Immunohistochemically, the tumor was positive for cytokeratin, epithelial membrane antigen, cluster of differentiation 117, synaptophysin and thyroid transcription factor-1, which indicated that the tumor was a SCC of the parotid gland. An extended resection of the right parotid gland mass and dissection of the facial nerve were performed. Following discharge from the hospital, the patient received radiation therapy postoperatively. The patient has remained disease free during five months of follow-up.
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Affiliation(s)
- Minda Liu
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
| | - Ming Zhong
- Department of Oral Pathology, Central Laboratory, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
| | - Changfu Sun
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
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Small-cell undifferentiated (neuroendocrine) carcinoma of the nasal cavity treated with concurrent chemoradiotherapy including irinotecan and cisplatin. Int Cancer Conf J 2014. [DOI: 10.1007/s13691-013-0106-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Joyce EA, Kavanagh J, Sheehy N, Beddy P, O'Keeffe SA. Imaging features of extrapulmonary small cell carcinoma. Clin Radiol 2013; 68:953-61. [PMID: 23790688 DOI: 10.1016/j.crad.2013.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 03/30/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
Small cell carcinoma accounts for approximately 20% of lung cancers; however, it rarely occurs at other sites. Extrapulmonary small cell carcinoma (EPSCC) is notoriously aggressive with a strong propensity for both regional and distant spread. The majority of the literature on these uncommon tumours is from a clinicopathological viewpoint with a relative paucity of detail regarding the radiological findings. This review will focus on the imaging features of EPSCC in its predominant sites of origin: the gastrointestinal tract, genitourinary tract, head, neck, and breast. We will also discuss the role of positron-emission tomography (PET)/computed tomography (CT) in the staging of EPSCC.
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Affiliation(s)
- E A Joyce
- Department of Radiology, St James's Hospital and Trinity College Dublin, Dublin, Ireland.
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Smith J, Reidy-Lagunes D. The Management of Extrapulmonary Poorly Differentiated (High-Grade) Neuroendocrine Carcinomas. Semin Oncol 2013; 40:100-8. [DOI: 10.1053/j.seminoncol.2012.11.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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