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Cobanoglu HB, Koprucu ER. Non-squamous Cancers of the Larynx. Curr Oncol Rep 2024; 26:625-632. [PMID: 38668924 PMCID: PMC11168984 DOI: 10.1007/s11912-024-01535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE OF REVIEW Although non-squamous tumors of the larynx are really rare, they may not always be viewed from the same perspective in the multidisciplinary treatment approach once the diagnosis is made. In this review, non-squamous tumors of the larynx and current approaches in treatment will be discussed. RECENT FINDINGS When the studies and meta-analyses presented in the last 5 years are evaluated, it is seen that these tumors usually show non-specific symptoms. Due to their submucosal location, the stage of the disease at the time of diagnosis is often advanced. In the literature, treatment may vary in these particular cases. The majority of non-squamous tumors of the larynx includes minor salivary gland tumors, neuroendocrine carcinomas, sarcomas, cartilage tumors, and malignant melanomas. Once treating a patient with these diagnoses, it should be kept in mind that the histopathological subtype is almost as important as the stage of the tumor.
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Affiliation(s)
- H Bengu Cobanoglu
- Faculty of Medicine, Department of Otorhinolaryngology Head & Neck Surgery, Karadeniz Technical University, Trabzon, Turkey.
| | - Erdal Rahman Koprucu
- Faculty of Medicine, Department of Otorhinolaryngology Head & Neck Surgery, Karadeniz Technical University, Trabzon, Turkey
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2
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Fuentes JDB, Fouda S, Evans E, Palaniappan N, Rackley T, Chan P, Evans M, Webster R. High-grade neuroendocrine head and neck cancer: Case series and review of the literature. Curr Probl Cancer 2024; 51:101105. [PMID: 38823286 DOI: 10.1016/j.currproblcancer.2024.101105] [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: 12/26/2023] [Revised: 05/12/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND High-grade neuroendocrine cancers (NEC) of the head and neck (HN) are rare and aggressive, accounting for ≤1 % of all HN cancers, with a 5-year overall survival (OS) of ≤20 %. This case series examines clinical characteristics, treatments, and outcomes of patients diagnosed at a regional UK HN cancer centre over the last 23 years. METHODS A retrospective review of medical records was conducted for all patients diagnosed with NEC HN from 1st January 2000 until 1st March 2023 at Velindre Cancer Centre. RESULTS During the study period, 19 cases of NEC HN were identified, primarily affecting males (n = 15, 79 %). Median age of 67 years (range: 44-86). At diagnosis, 32 % of patients (n = 6) were smokers. The most common primary tumour sites were larynx (n = 5, 26.3 %) and sinonasal (n = 5, 26.3 %). Most patients presented with advanced loco-regional disease or distant metastasis, with stage IVA (n = 6, 32 %) and stage IVC (n = 6, 32 %) being the most common. The key pathology marker was synaptophysin, present in 100 % of the tested patients (n = 15). In the study, of the 12 patients with non-metastatic disease, 10 received a combination of treatments that included radiotherapy (RT). Some of these patients also received chemotherapy (CT) at the same time as their radiotherapy. Surgery alone was used in two patients with stage II disease. Seven subjects had complete responses, and one achieved a partial response. Among the seven metastatic patients, three received CT, and one underwent palliative RT, all achieving a partial response. In all cases, the CT used was carboplatin and etoposide. After a median follow-up of 11 months (range: 1-96), the median OS was 27 months for the overall population, 51 months for those treated radically, and three months for metastatic patients with palliative treatment. The 1-year OS for all patients was 54.3 %, the 2-year OS was 46.5 %, and the 5-year OS was 23.3 %. Among patients treated radically, these rates were 65.3 %, 52.2 %, and 26.1 %, respectively. For patients treated palliatively, the 1-year OS was 33.3 %. CONCLUSION This case series contributes preliminary observations on the characteristics and management of non-metastatic NEC HN, suggesting potential benefits from multimodality treatment strategies. Given the small cohort size, these observations should be interpreted cautiously and seen as a foundation for further research.
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Affiliation(s)
- Javier David Benitez Fuentes
- Velindre Cancer Centre, Cardiff, United Kingdom; Medical Oncology, Centro Integral Oncologico Clara Campal (CIOCC), Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - Sally Fouda
- Velindre Cancer Centre, Cardiff, United Kingdom.
| | - Elin Evans
- Velindre Cancer Centre, Cardiff, United Kingdom.
| | | | | | - Po Chan
- Velindre Cancer Centre, Cardiff, United Kingdom.
| | - Mererid Evans
- Velindre Cancer Centre, Cardiff, United Kingdom; Cardiff University, Wales, United Kingdom.
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3
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Singh A, Kushwaha R, Chauhan P, Kumar G. Primary neuroendocrine carcinoma of cervical lymph node masquerading as non-Hodgkin lymphoma: A diagnostic challenge. J Cancer Res Ther 2023:01363817-990000000-00031. [PMID: 38102915 DOI: 10.4103/jcrt.jcrt_2572_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/02/2023] [Indexed: 12/17/2023]
Abstract
ABSTRACT A large extended family of tumors classified as neuroendocrine tumors most commonly occurs in the gastrointestinal tract and bronchus pulmonary tree. It is extremely unusual for a primary neuroendocrine tumor to present as a cervical lymph node mass at initial presentation. We discuss the rare case of a 55-year-old man who initially complained of a right neck mass that was misinterpreted as non-Hodgkin lymphoma on fine needle aspiration cytology. By integrating clinical findings, radiography, fine-needle aspiration cytology, histomorphology, and immunohistochemistry analysis, a definitive diagnosis of primary neuroendocrine carcinoma of the cervical lymph node was made. He received chemotherapy and decompressive radiation as treatment. Regarding the course of disease in the present case, the patients underwent a distant subcutaneous metastasis over the right anterior chest wall 10 months after the initial manifestation. The patient is still alive, albeit his general condition has gotten deteriorated, and he is getting regular follow-ups.
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Affiliation(s)
- Anurag Singh
- Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India
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4
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Paquin R, Gill B, Martin E, Byrd JK. Base of tongue neuroendocrine carcinoma: A case report. Oral Oncol 2022; 129:105780. [DOI: 10.1016/j.oraloncology.2022.105780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022]
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Rossi NA, Gietzen R, Malaya LT, Haroun KB, Conner GR, Coblens O, Resto VA, Clement CG, Joshi R. Combined large cell neuroendocrine carcinoma and squamous cell carcinoma of the oropharynx: A collision course of tumors. Clin Case Rep 2022; 10:e05319. [PMID: 35127091 PMCID: PMC8795838 DOI: 10.1002/ccr3.5319] [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: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/07/2022] Open
Abstract
Combined large cell neuroendocrine carcinoma (LCNEC) and squamous cell carcinoma (SCC) of the H&N are exceptionally rare. We present the case of combined p16 negative SCC and LCNEC of the oropharynx treated with combination chemotherapy. This is the third reported case of combined neuroendocrine carcinoma and SCC of the oropharynx.
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Affiliation(s)
- Nicholas A. Rossi
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Rachelle Gietzen
- Department of PathologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Lauren T. Malaya
- School of MedicineUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Kareem B. Haroun
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Grant R. Conner
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Orly Coblens
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Vicente A. Resto
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Cecilia G. Clement
- Department of PathologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Rohan Joshi
- Department of OtolaryngologyUniversity of Texas Medical BranchGalvestonTexasUSA
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6
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Sousa LG, Lazar Neto F, Torman DK, Diaz EM, Rosenthal DI, Glisson BS, Bell D, Ferrarotto R. Therapeutic approaches and outcomes in patients with larynx or hypopharynx high-grade neuroendocrine carcinoma: A single-center retrospective analysis. Head Neck 2021; 43:3788-3795. [PMID: 34524729 DOI: 10.1002/hed.26865] [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: 03/25/2021] [Revised: 07/06/2021] [Accepted: 09/01/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND High-grade neuroendocrine carcinoma of the larynx (HG-NECL) is rare and aggressive with limited data regarding response to systemic therapy. We evaluated clinicopathological features, therapeutic approaches, and outcomes in patients with laryngeal or hypopharyngeal HG-NECL. METHODS Data were retrospectively collected through 1997-2020. Median disease-free (mDFS), progression-free (mPFS), and overall survival (mOS) were estimated using the Kaplan-Meier method. RESULTS Fifteen patients were identified; most had locoregional (N = 7) or metastatic disease (N = 5). The main curative-intent treatment was chemoradiation concurrent with platinum-based chemotherapy; the rate of complete response was 78%. Most patients (80%) developed recurrence; the mDFS was 13.1 months. For the first-line palliative therapy, the ORR and mPFS were 50% and 3.1 months, respectively. For all patients, the mOS was 17.8 months, and 8.6 months for metastatic disease. CONCLUSION Laryngeal HG-NEC is associated with high relapse rates and dismal prognosis for those with recurrent/metastatic disease. Novel therapeutic strategies are needed.
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Affiliation(s)
- Luana Guimaraes Sousa
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Felippe Lazar Neto
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Danice Karagiannis Torman
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo M Diaz
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Bonnie S Glisson
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Diana Bell
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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7
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Agea Martínez M, Navarro Cuéllar I, Sada Urmeneta A, Alijo Serrano F, Navarro Cuéllar C. Large cell neuroendocrine carcinoma on the floor of the mouth: a rare entity in an unusual location. Int J Oral Maxillofac Surg 2021; 51:742-745. [PMID: 34481737 DOI: 10.1016/j.ijom.2021.08.021] [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: 04/01/2021] [Revised: 06/22/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
Neuroendocrine carcinomas (NEC) are a group of malignant neoplasms usually located in the lungs or gastrointestinal tract. Fewer cases are located in the head and neck, and in these rare presentations, the lingual tonsil, larynx, and major salivary glands are the most frequently affected sites. NECs exhibit similar characteristics regardless of where they arise. However, because these neoplasms are rare, a clear understanding of their aetiopathogenesis has yet to be described, and options for treatment have varied and are not unified. A rare NEC of the floor of the mouth is reported here; it appears that this location has not been reported previously. The diagnosis was established through histopathological analysis, and the patient underwent systemic treatment. He had a partial response to treatment in the first 3 months, but died 6 months after the initial diagnosis. This highly uncommon tumour can pose a significant diagnostic challenge for clinicians and pathologists alike and can result in diagnostic delay.
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Affiliation(s)
- M Agea Martínez
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; XXX.
| | - I Navarro Cuéllar
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Sada Urmeneta
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - F Alijo Serrano
- Pathological Anatomy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C Navarro Cuéllar
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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8
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Yan O, Xie W, Teng H, Fu S, Chen Y, Liu F. Nomograms Forecasting Long-Term Overall and Cancer Specific Survival of Patients With Head and Neck Neuroendocrine Carcinoma. Front Oncol 2021; 11:619599. [PMID: 33659217 PMCID: PMC7917297 DOI: 10.3389/fonc.2021.619599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/08/2021] [Indexed: 02/05/2023] Open
Abstract
Background The purpose of this retrospective analysis was to build and validate nomograms to predict the cancer-specific survival (CSS) and overall survival (OS) of head and neck neuroendocrine carcinoma (HNNEC) patients. Methods A total of 493 HNNEC patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015, and 74 HNNEC patients were collected from the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital (HCH) between 2008 and 2020. Patients from SEER were randomly assigned into training (N=345) and internal validation (N=148) groups, and the independent data group (N=74) from HCH was used for external validation. Independent prognostic factors were collected using an input method in a Cox regression model, and they were then included in nomograms to predict 3-, 5-, and 10-year CSS and OS rates of HNNEC patients. Finally, we evaluated the internal and external validity of the nomograms using the consistency index, while assessing their prediction accuracy using calibration curves. A receiver operating curve (ROC) was also used to measure the performance of the survival models. Results The 3-, 5-, and 10-year nomograms of this analysis demonstrated that M classification had the largest influence on CSS and OS of HNNEC, followed by the AJCC stage, N stage, age at diagnosis, sex/gender, radiation therapy, and marital status. The training validation C-indexes for the CSS and OS models were 0.739 and 0.713, respectively. Those for the internal validation group were 0.726 and 0.703, respectively, and for the external validation group were 0.765 and 0.709, respectively. The area under the ROC curve (AUC) of 3-, 5-, and 10-year CSS and OS models were 0.81, 0.82, 0.82, and 0.78, 0.81, and 0.82, respectively. The C-indexes were all higher than 0.7, indicating the high accuracy ability of our model's survival prediction. Conclusions In this study, prognosis nomograms in HNNEC patients were constructed to predict CSS and OS for the first time. Clinicians can identify patients' survival risk better and help patients understand their survival prognosis for the next 3, 5, and 10 years more clearly by using these nomograms.
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Affiliation(s)
- Ouying Yan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Wenji Xie
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Haibo Teng
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shengnan Fu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Yanzhu Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Feng Liu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China.,Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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9
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Tosios KI, Papanikolaou V, Vlachodimitropoulos D, Goutas N. Primary Large Cell Neuroendocrine Carcinoma of the Parotid Gland. Report of a Rare Case. Head Neck Pathol 2021; 15:1377-1384. [PMID: 33544384 PMCID: PMC8633209 DOI: 10.1007/s12105-021-01300-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Abstract
Primary neuroendocrine carcinomas of the salivary glands are very rare neoplasms that present light microscopic, ultrastructural, and immunohistochemical features of neuroendocrine differentiation. Twelve cases have been published in the English language literature. We describe the pathologic features of a case of primary large cell neuroendocrine carcinoma of the parotid gland in a 91-year old male and summarize the immunophenotype of previously reported LCNECs of the major salivary glands. It is concluded that primary LCNEC of the salivary glands presents as a high-grade undifferentiated carcinoma, whose diagnosis may be hindered by its rarity and non-specific light microscopic features. A high level of awareness, immunohistochemical staining for neuroendocrine markers synaptophysin and CD56, and a thorough diagnostic work-up in order to exclude metastasis from a primary neuroendocrine carcinoma will allow its diagnosis.
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Affiliation(s)
- Konstantinos I. Tosios
- Department of Oral Medicine and Pathology, Dental School, National and Kapodistrian University of Athens, 2 Thivon Street, 11527 Athens, Greece
| | - Vasileios Papanikolaou
- 1St ENT Department, Medical School, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachodimitropoulos
- Laboratory of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Goutas
- Laboratory of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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10
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Iyoda A, Azuma Y, Sano A. Neuroendocrine tumors of the lung: clinicopathological and molecular features. Surg Today 2020; 50:1578-1584. [PMID: 32193632 DOI: 10.1007/s00595-020-01988-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/28/2020] [Indexed: 12/19/2022]
Abstract
In 1970, neuroendocrine tumors of the lung were classified into three categories: typical carcinoid (TC), atypical carcinoid (AC), and small cell lung carcinoma (SCLC). The third edition of the World Health Organization (WHO) classification in 1999 defined large cell neuroendocrine carcinoma (LCNEC) as a variant of large cell carcinomas, whereas the fourth edition of the WHO classification redefined LCNEC as a neuroendocrine tumor. Currently, neuroendocrine tumors of the lung are classified into four main categories: TC, AC, LCNEC, and SCLC. Although the treatments for TC, AC, and SCLC have not changed remarkably, the treatment strategy for LCNEC is not yet established because of its reclassification from a variant of "large cell carcinoma" to a new category of "neuroendocrine tumor". In this review article, we discuss the pathological findings, biological behavior, and treatment of neuroendocrine tumors of the lung.
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Affiliation(s)
- Akira Iyoda
- Division of Chest Surgery, Department of Surgery, School of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Yoko Azuma
- Division of Chest Surgery, Department of Surgery, School of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Atsushi Sano
- Division of Chest Surgery, Department of Surgery, School of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
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11
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Mascitti M, Luconi E, Togni L, Rubini C. Large cell neuroendocrine carcinoma of the submandibular gland: a case report and literature review. Pathologica 2020; 111:70-75. [PMID: 31388199 DOI: 10.32074/1591-951x-13-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022] Open
Abstract
Neuroendocrine tumors (NET) are a heterogeneous group of malignancies with a broad spectrum of histomorphologies, tissue origins, and clinical outcomes, which arise from neural crest cells with neuroendocrine differentiation. Salivary gland tumors account for 3-6% of all head and neck neoplasms, while large cell neuroendocrine carcinomas (LCNEC) of the salivary gland are extremely rare, with few cases reported in literature, and only 5 cases involving submandibular gland. The rarity of these tumors in salivary glands is probably related to the scarcity of neuroendocrine cells in this tissue, whose presence is still a matter of debate. Regardless of their low frequency, it is imperative to differentiate these tumors from the much more common squamous cell carcinomas and metastatic NETs, due to different therapeutic approach and prognosis. In this paper, we report the case of a 21-year-old man, with a LCNEC involving a submandibular gland followed by several recurrences over the years. In addition, we include a comprehensive review of the available literature on this topic.
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Affiliation(s)
- M Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - E Luconi
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - L Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - C Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
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12
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Strosberg C, Ferlito A, Triantafyllou A, Gnepp DR, Bishop JA, Hellquist H, Strojan P, Willems SM, Stenman G, Rinaldo A, Hernandez-Prera JC. Update on Neuroendocrine Carcinomas of the Larynx. Am J Clin Pathol 2019; 152:686-700. [PMID: 31415081 DOI: 10.1093/ajcp/aqz106] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Laryngeal neuroendocrine carcinomas are heterogeneous neoplasms characterized by neuroendocrine differentiation. Their prognoses are dependent on tumor type, therefore different classifications have been developed. Moreover, other tumors have overlapping pathologic features posing a range of diagnostic possibilities. METHODS A review of the literature was performed to comprehensively understand the classification and diagnosis of these tumors. RESULTS We review the past and present classification systems, with emphasis to the latest 2017 World Health Organization Classification of Head and Neck Tumors. We highlight salient clinicopathologic features and discuss the presumptive etiologic role of human papilloma virus. We share a practical algorithmic approach to the diagnosis of suspected neuroendocrine neoplasms of the larynx including a novel marker for neuroendocrine differentiation, insulinoma-associated protein 1. CONCLUSIONS Accurate diagnosis and grading of laryngeal neuroendocrine carcinomas is critical for prognostication and therapeutic decision making. The use of an algorithm is instrumental in assuring the exclusion of mimickers.
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Affiliation(s)
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
| | - Asterios Triantafyllou
- Department of Pathology, Liverpool Clinical Laboratories and School of Dentistry, University of Liverpool, Liverpool, UK
| | - Douglas R Gnepp
- Warren Alpert Medical School at Brown University, Providence, RI
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas
| | - Henrik Hellquist
- Centre for Biomedical Research, Department of Biomedical Sciences and Medicine, Faro, Portugal
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, Faro, Portugal
- Algarve Biomedical Centre, Campus Gambelas, University of Algarve, Faro, Portugal
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Göran Stenman
- Department of Pathology and Genetics, Sahlgrenska Cancer Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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13
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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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14
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Zhao Q, Wei J, Zhang C, Meng L, Wang B, Gao L, Jiang X. Large-cell neuroendocrine carcinoma of nasal cavity and paranasal sinuses after successful curative therapy: a case report and literature review. Onco Targets Ther 2019; 12:2975-2980. [PMID: 31114241 PMCID: PMC6489553 DOI: 10.2147/ott.s195052] [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: 11/18/2018] [Accepted: 02/28/2019] [Indexed: 02/03/2023] Open
Abstract
This report describes a 40-year-old male patient with symptoms affecting the nasal sinuses including nasal obstruction and olfactory anesthesia. Magnetic resonance imaging demonstrated that the tumor eroded the adjacent bone and bilateral frontal lobes. The biopsy sample of the left nasal mass was processed for both H&E staining and immunohistological staining for various markers. The final histological examination showed large-cell neuroendocrine carcinoma with poor differentiation. After a general evaluation, the patient was staged as cT4bN0M0. The patient was treated by combined radiotherapy and chemotherapy. The treatment yielded almost complete remission, and after 10 months of follow-up, no distant organ metastasis or recurrence in the primary tumor region was detected.We report this rare case and review the current literature of this tumor.
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Affiliation(s)
- Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Jinlong Wei
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Chengbin Zhang
- Department of pathology, the First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Lingbin Meng
- Department of Internal Medicine, Florida Hospital, Orlando, FL 32804, USA
| | - Bin Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Ling Gao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
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15
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How phenotype guides management of the neuroendocrine carcinomas of the larynx. The Journal of Laryngology & Otology 2018; 132:568-574. [DOI: 10.1017/s0022215118000968] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractObjectiveThis review aimed to critically analyse data pertaining to the clinical presentation and treatment of neuroendocrine carcinomas of the larynx.MethodA PubMed search was performed using the term ‘neuroendocrine carcinoma’. English-language articles on neuroendocrine carcinoma of the larynx were reviewed in detail.Results and conclusionWhile many historical classifications have been proposed, in contemporary practice these tumours are sub-classified into four subtypes: carcinoid, atypical carcinoid, small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma. These tumours exhibit a wide range of biological behaviour, ranging from the extremely aggressive nature of small and large cell neuroendocrine carcinomas, which usually have a fatal prognosis, to the less aggressive course of carcinoid tumours. In small and large cell neuroendocrine carcinomas, a combination of irradiation and chemotherapy is indicated, while carcinoid and atypical carcinoid tumour management entails conservation surgery.
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16
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Abstract
The differential diagnosis of neuroendocrine neoplasms of the larynx is broad and includes lesions of epithelial, mesenchymal, and neuroectodermal origin. These lesions have overlapping clinical and pathologic aspects and must be carefully considered in the differential diagnosis of laryngeal neoplasms. The prognosis and treatment are also different among these tumor types, which necessitates making these distinctions clinically. The current literature was reviewed to provide updated information regarding the epithelial-derived tumors, including carcinoid, atypical carcinoid, small cell neuroendocrine carcinomas, large cell neuroendocrine carcinoma, and squamous cell carcinoma with neuroendocrine component. These tumors are compared and contrasted with non-epithelial-derived tumors such as paraganglioma and nonmucosal tumors, such as medullary thyroid carcinoma. The morphologic and cytologic features are discussed, along with helpful immunohistochemical and ancillary investigations.
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17
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Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: What is New in the 2017 WHO Blue Book for Tumours of the Hypopharynx, Larynx, Trachea and Parapharyngeal Space. Head Neck Pathol 2017; 11:23-32. [PMID: 28247231 PMCID: PMC5340729 DOI: 10.1007/s12105-017-0788-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/02/2017] [Indexed: 01/08/2023]
Abstract
Chapter 3 "Tumours of the hypopharynx, larynx, trachea, and parapharyngeal space" of the World Health Organization (WHO) Blue Book 2017 "Classification of Head and Neck Tumours" shows a shortened list of entities, especially due to reducing the number of benign and malignant soft tissue tumours, malignant melanoma and some others, which are transferred to more frequently affected regions of the head and neck. The basic concept of the new edition is to assimilate all advances concerning the discussed tumours in a shorter framework, appropriate for daily work. The main emphasis is on the most frequent lesions and tumors originating from the covering squamous epithelium. Laryngeal and hypopharyngeal conventional squamous cell carcinoma (CSCC), its variants and precursor lesions, occupy a major part of the chapter. New data on etiopathogenesis, with the focus on human papillomavirus (HPV) infection, are discussed in relation to the entities of the squamous epithelium. Although only a small fraction of these lesions are HPV-related, further studies are required for evaluation of the potential prognostic and therapeutic benefit of mRNA HPV determination. In contrast to earlier data, laryngeal and hypopharyngeal verrucous SCC, spindle cell SCC and basaloid SCC are not anymore considered as HPV-related tumours. New data on the pathogenesis of spindle cell SCC exhibiting divergent differentiation by epithelial-mesenchymal transition, are also briefly discussed. The most important innovation is brought by the section on precursor lesions, in which a unified two-tier classification, consisting of low- and high-grade dysplasia, is introduced. The proposed two-tier system can also be transformed into a three-tier classification for treatment purposes, with a distinction between carcinoma in situ and high-grade dysplasia. The reviewed morphological criteria of the proposed system are based on the amended Ljubljana classification. The section on laryngeal neuroendocrine carcinomas (NEC) represents a considerable improvement in terminology and classification. NEC are divided into well-, moderate- and poorly-differentiated neuroendocrine carcinoma. The latter is additionally divided into small cell NEC and large cell NEC (LCNEC). It is of extreme importance that LCNEC, which was associated in the WHO 2005 edition with atypical carcinoid/moderately differentiated neuroendocrine carcinoma, grade II, has now been transferred into the group of poorly differentiated NEC, grade III, displaying a specific morphology and poorer prognosis.
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18
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Nagase K, Kimura H, Yonekura N, Koba S, Inoue T, Narisawa Y. Large-cell neuroendocrine carcinoma of the skin: ultrastructural and immunohistochemical findings. J Cutan Pathol 2016; 43:1067-1073. [DOI: 10.1111/cup.12794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/28/2016] [Accepted: 08/08/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Kotaro Nagase
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
| | - Hiromi Kimura
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
| | - Naomi Yonekura
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
| | - Shinichi Koba
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
| | - Takuya Inoue
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
| | - Yutaka Narisawa
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine; Saga University; Saga Japan
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19
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Large Cell Neuroendocrine Carcinoma of the Head and Neck: A Clinicopathologic Series of 10 Cases With an Emphasis on HPV Status. Am J Surg Pathol 2016; 40:471-8. [PMID: 26735857 DOI: 10.1097/pas.0000000000000580] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Large cell neuroendocrine carcinoma (LCNEC) is a high-grade neuroendocrine neoplasm first described in the lung and subsequently well documented in many other anatomic sites. It has only recently been recognized that LCNEC can also occasionally arise in the head and neck. The role of human papillomavirus (HPV), which is associated with some small cell carcinomas of the head and neck, has not been investigated for LCNEC. We sought to further characterize the histologic, immunophenotypic, and clinical features of LCNEC and also investigate the role of HPV in this newly described group of tumors. The surgical pathology archives of 2 large academic institutions were searched for cases of LCNEC arising in the head and neck. p16 immunohistochemistry and HPV in situ hybridization were performed, and clinical information was obtained from electronic medical records. Ten cases of head and neck LCNEC were identified. The tumors arose in 6 men and 4 women ranging in age from 14 to 70 years (median, 63.5 y). The primary tumor sites were the oropharynx (n=4), the sinonasal tract (n=3), and the larynx (n=3). The LCNECs consisted of nests and trabeculae of medium-large cells with abundant cytoplasm, coarse chromatin, and prominent nucleoli with very high mitotic rates. The tumor nests were often associated with necrosis, peripheral palisading, and rosette formations. The LCNECs were positive for pan-cytokeratin and at least 1 neuroendocrine marker (most often synaptophysin) and were largely negative for p63 (focal staining in 2/10) and CK5/6 (staining in 1/10). The LCNECs demonstrated aggressive clinical behavior: 8 of 10 presented with advanced disease, 5 of 10 died, with 4 more living but with persistent tumor. Three of 10 LCNECs were HPV-related (HPV-LCNEC); they arose in the oropharynx (n=2) and sinonasal tract (n=1). The HPV-LCNECs did not differ from the HPV-negative tumors in histologic appearance or behavior: 2 patients with HPV-LCNEC have died because of their disease and 1 remains alive but with widespread metastases. LCNEC is a rare but distinct form of head and neck carcinoma that exhibits aggressive clinical behavior. A subset of oropharyngeal and sinonasal LCNEC is HPV related, but the presence of HPV may not impart a more favorable prognosis. Because of its aggressive behavior, LCNEC should be distinguished from moderately differentiated neuroendocrine carcinoma and squamous cell carcinoma. The morphology of LCNEC overlaps considerably with the nonkeratinizing appearance of HPV-related squamous cell carcinoma, and as a result a high index of suspicion is needed to identify LCNEC. Immunohistochemical studies for synaptophysin and p63 are helpful tools for making this distinction.
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20
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Andreasen S, Persson M, Kiss K, Homøe P, Heegaard S, Stenman G. Genomic profiling of a combined large cell neuroendocrine carcinoma of the submandibular gland. Oncol Rep 2016; 35:2177-82. [PMID: 26883388 DOI: 10.3892/or.2016.4621] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 01/05/2016] [Indexed: 11/06/2022] Open
Abstract
A 69-year-old female with no previous medical history presented with a rapidly growing submandibular mass. Fine needle aspiration cytology suggested a small-cell carcinoma and PET-CT showed increased 18-FDG uptake in the submandibular mass as well as in a lung mass. Submandibular resection and selective neck dissection was performed and histopathologic examination revealed a combined large-cell neuroendocrine carcinoma (LCNEC) with a squamous component and without lymph node metastases. Resection of the lung tumor revealed a papillary adenocarcinoma that was morphologically distinctly different from the LCNEC. The patient died of her lung cancer after 19 months without evidence of recurrence of the LCNEC. Genomic profiling of the salivary gland LCNEC revealed a hypodiploid genome predominated by losses of whole chromosomes or chromosome arms involving chromosomes 3p, 4, 7q, 10, 11, 13, 16q and gains of 3q and 16p. In addition, there was a segmental gain of 9p23-p22.3 including the NFIB oncogene. Continued studies of salivary gland LCNEC may provide new knowledge concerning potential diagnostic biomarkers and may ultimately also lead to the identification of new treatment targets for patients with these aggressive carcinomas.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Marta Persson
- Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Gothenburg, Sweden
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Køge, Denmark
| | | | - Göran Stenman
- Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Gothenburg, Sweden
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21
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Shah K, Perez-Ordóñez B. Neuroendocrine Neoplasms of the Sinonasal Tract: Neuroendocrine Carcinomas and Olfactory Neuroblastoma. Head Neck Pathol 2016; 10:85-94. [PMID: 26830400 PMCID: PMC4746139 DOI: 10.1007/s12105-016-0696-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/05/2015] [Indexed: 01/27/2023]
Abstract
Neuroendocrine neoplasms (NENs) can occur in organs or tissues that do not contain neuroendocrine cells normally and do not necessarily imply embryologic derivation from the neuroectoderm; but rather reflect a shared phenotype characterized by the expression of multiple genes encoding both endocrine and neuronal features. NENs are rare in the sinonasal tract and are subdivided into epithelial and neural subtypes based on the presence of keratins or neurofilaments, respectively. Although relatively rare, neuroendocrine carcinomas (NECs) and olfactory neuroblastoma (ONB) are the most common neuroendocrine neoplasms of the sinonasal tract. The focus of this review is to highlight recent developments in the pathology of sinonasal NECs and ONB in light of the upcoming update of the World Health Organization (WHO) 2005 classification of tumors of the head and neck.
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Affiliation(s)
- Ketan Shah
- Department of Pathology, John Radcliffe Hospital, Oxford, UK
| | - Bayardo Perez-Ordóñez
- Department of Pathology, John Radcliffe Hospital, Oxford, UK ,Laboratory Medicine Program, Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada
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22
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Kadowaki Y, Hirano T, Nomi N, Suzuki M. [A Case of Oropharyngeal Large Cell Neuroendocrine Carcinoma]. ACTA ACUST UNITED AC 2015; 118:1143-9. [PMID: 26615665 DOI: 10.3950/jibiinkoka.118.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The large cell neuroendocrine carcinoma (LCNEC) of the lung was first reported in detail by Travis et al. in 1991. Extrapulmonary LCNEC rarely occurs, and only 22 cases have been reported in the head and neck mucosal regions. Today LCNEC of the larynx is contained in the moderately differentiated/Grade 2 category. However some authors advocate that LCNEC of the larynx should be separated from this category because of the difference in the clinical manifestations and pathological features. Standard treatment for head and neck mucosal LCNEC (M-LCNEC) has not been confirmed. However we suggested the efficacy of postoperative chemotherapy for M-LCNEC. This report describes a case of an LCNEC of the oropharynx. The patient was a 64-year-old man. We treated him with surgery and chemoradiotherapy. He has been disease-free for 36 months after adjuvant-chemotherapy.
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23
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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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24
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Ferlito A, Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Devaney KO, Hunt JL, Perez-Ordoñez B, Slootweg PJ, Bell D, Bishop JA, Rinaldo A. New tumor phenotypes reported in the larynx in the last decades: a critique. Am J Otolaryngol 2015; 36:494-7. [PMID: 25725968 DOI: 10.1016/j.amjoto.2015.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy.
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Asterios Triantafyllou
- Pathology Department, Liverpool Clinical Laboratories and Oral & Maxillofacial Pathology, School of Dentistry, University of Liverpool, Liverpool, UK
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Bayardo Perez-Ordoñez
- Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Pieter J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Diana Bell
- Department of Pathology, MD Anderson Cancer Center, Houston, TX
| | - Justin A Bishop
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD
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25
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Zhou C, Duan X, Liao D, Liao J, Shen J. CT and MR findings in 16 cases of primary neuroendocrine carcinoma in the otolaryngeal region. Clin Imaging 2015; 39:194-9. [PMID: 25457524 DOI: 10.1016/j.clinimag.2014.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 02/05/2023]
Abstract
Primary neuroendocrine carcinoma (NEC) is a rare malignancy in the otolaryngeal region. Computed tomography and magnetic resonance imaging findings in 16 patients with primary otolaryngeal NECs were summarized. Most of tumors occurred in the sinonasal cavity (n=9; 56.3%), then supraglottis (n=3; 18.8%). All sinonasal and one hard palate tumors were ill defined, and the other tumors were well defined. All lesions showed moderate to marked enhancement, but homogeneously in well-differentiated tumors while heterogeneously in most of poorly differentiated tumors. Most sinonasal tumors were poorly differentiated and invaded adjacent bones. Primary otolaryngeal NECs might have some distinct features related to their origin and differentiation.
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Affiliation(s)
- Cuiping Zhou
- Department of Radiology, The Huizhou Central municipal Hospital, No.41 Eling Rood North, Huizhou, 516001 Guangdong China.
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-Sen Memorial Hospital, SunYat-Sen University, No.107 Yanjiang Road West, Guangzhou, 510120 Guangdong, China.
| | - Danling Liao
- Department of Radiology, First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515041 Guangdong China.
| | - Junjie Liao
- Department of Radiology, The Huizhou Central municipal Hospital, No.41 Eling Rood North, Huizhou, 516001 Guangdong China.
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, SunYat-Sen University, No.107 Yanjiang Road West, Guangzhou, 510120 Guangdong, China.
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26
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Ferlito A, Strojan P, Lewis JS, Perez-Ordoñez B, Rinaldo A. Large cell neuroendocrine carcinoma of the head and neck: a distinct clinicopathologic entity. Eur Arch Otorhinolaryngol 2014; 271:2093-5. [PMID: 24831455 DOI: 10.1007/s00405-014-3090-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Alfio Ferlito
- University of Udine School of Medicine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy,
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27
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Elloumi F, Fourati N, Siala W, Ghorbell L, Jlidi R, Ghorbel A, Frikha M, Daoud J. [Large cell neuroendocrine carcinoma of the nasopharynx: A case report]. Cancer Radiother 2014; 18:208-10. [PMID: 24837649 DOI: 10.1016/j.canrad.2014.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 02/08/2014] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
Abstract
Neuroendocrine carcinoma of the head and neck is a rare entity. The parotid gland is the most commonly affected site. A nasopharyngeal site has not been previously described. We report a 35-year-old patient who consulted for tinnitus and nasal obstruction. The assessment found a nasopharyngeal tumour T4N0M0. The patient underwent 6 cycles of chemotherapy based on VP16 and cisplatin, followed by radiotherapy at a dose of 70 Gy to the nasopharynx and 50 Gy to the neck. The evolution was marked by clinical improvement and radiological stability. Six months after the end of treatment, the patient had a local and meningeal relapse. He received palliative care. He died 19 months after the end of treatment.
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Affiliation(s)
- F Elloumi
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie
| | - N Fourati
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie.
| | - W Siala
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie
| | - L Ghorbell
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie
| | - R Jlidi
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie
| | - A Ghorbel
- Service d'ORL, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Frikha
- Service de carcinologie médicale, CHU Habib Bourguiba, Sfax, Tunisie
| | - J Daoud
- Service de radiothérapie oncologique, CHU Habib Bourguiba, Sfax, Tunisie
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28
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Iyoda A, Makino T, Koezuka S, Otsuka H, Hata Y. Treatment options for patients with large cell neuroendocrine carcinoma of the lung. Gen Thorac Cardiovasc Surg 2014; 62:351-6. [PMID: 24719260 PMCID: PMC4042022 DOI: 10.1007/s11748-014-0379-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Indexed: 11/27/2022]
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the lung is categorized as a variant of large cell carcinomas, and LCNEC tumors display biological behaviors resembling those of small cell lung carcinomas and features of high-grade neuroendocrine tumors. Because patients with LCNEC have a poor prognosis, surgery alone is not sufficient. Multimodality therapies, including adjuvant chemotherapy, appear promising for improved prognosis in patients with LCNEC. In this review article, we discuss treatment options for patients with LCNEC of the lung.
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Affiliation(s)
- Akira Iyoda
- Division of Chest Surgery, Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan,
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29
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Xu B, Chetty R, Perez-Ordoñez B. Neuroendocrine neoplasms of the head and neck: some suggestions for the new WHO classification of head and neck tumors. Head Neck Pathol 2014; 8:24-32. [PMID: 24595420 PMCID: PMC3950384 DOI: 10.1007/s12105-014-0531-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/19/2014] [Indexed: 10/25/2022]
Abstract
As knowledge and understanding in pathology evolve, classifications and nomenclature also change to reflect those advances. The 2005 World Health Organization Classification of Head and Neck Tumours was a significant step towards diagnostic standardization of head and neck neuroendocrine carcinomas; however, in the last 10 years there have been new data supporting the recognition of "large cell neuroendocrine carcinoma" as a distinctive high grade carcinoma in the head and neck, a lesion not included in the 2005 Classification. In addition, the terms "middle ear adenoma" and "carcinoid tumor of middle ear" are still widely used to describe a neoplasm that is neither a pure adenoma nor a carcinoid tumor but a lesion with variable mixed exocrine and endocrine differentiation. Largely using the diagnostic criteria of the WHO classification of neuroendocrine carcinomas of the lung, we propose the terms "neuroendocrine carcinoma, grade 1"; "neuroendocrine carcinoma, grade 2"; "neuroendocrine carcinoma, grade 3, large cell type"; and "neuroendocrine carcinoma, grade 3, small cell type" for the classification of neuroendocrine carcinomas of the head and neck in a future WHO classification. In addition, we also proposed the term "mixed epithelial neuroendocrine tumor" of the middle ear as an alternative for "middle ear adenoma" and "carcinoid tumor of the middle ear".
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Affiliation(s)
- Bin Xu
- grid.63984.300000000090644811Department of Pathology, McGill University Health Center, Montreal, QC Canada
| | - Runjan Chetty
- grid.231844.80000000404740428Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada ,grid.17063.33Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Bayardo Perez-Ordoñez
- grid.231844.80000000404740428Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada ,grid.17063.33Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
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30
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Wu BZ, Gao Y, Yi B. Primary neuroendocrine carcinoma in oral cavity: two case reports and review of the literature. J Oral Maxillofac Surg 2013; 72:633-44. [PMID: 24215661 DOI: 10.1016/j.joms.2013.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/12/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
Abstract
Neuroendocrine carcinoma (NEC) is a tumor that occurs in different locations, particularly the lungs and larynx. The oral cavity is a rare site for a primary NEC. This report describes 2 cases of primary NEC in the oral cavity. Case 1 occurred in the anterior mandibular gingiva in a 25-year-old woman and presented with a special histologic appearance. This patient showed no evidence of recurrence 13 months after marginal resection of the anterior mandible. Case 2 was a primary NEC with some foci of squamous cell differentiation arising in the right buccal region in a 38-year-old woman. This patient showed no evidence of disease 8 months after tumor resection and postoperative iodine-125 brachytherapy. To the best of the authors' knowledge, case 1 is the youngest patient with NEC reported in the oral cavity to date in the English-language literature, and case 2 is the first report of a primary NEC in the buccal region.
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Affiliation(s)
- Bin-Zhang Wu
- Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Gao
- Professor, Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Biao Yi
- Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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31
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Subedi N, Prestwich R, Chowdhury F, Patel C, Scarsbrook A. Neuroendocrine tumours of the head and neck: anatomical, functional and molecular imaging and contemporary management. Cancer Imaging 2013; 13:407-22. [PMID: 24240099 PMCID: PMC3830426 DOI: 10.1102/1470-7330.2013.0034] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Neuroendocrine tumours (NETs) of the head and neck are rare neoplasms and can be of epithelial or non-epithelial differentiation. Although the natural history of NETs is variable, it is crucial to establish an early diagnosis of these tumours as they can be potentially curable. Conventional anatomical imaging and functional imaging using radionuclide scintigraphy and positron emission tomography/computed tomography can be complementary for the diagnosis, staging and monitoring of treatment response. This article describes and illustrates the imaging features of head and neck NETs, discusses the potential future role of novel positron-emitting tracers that are emerging into clinical practice and reviews contemporary management of these tumours. Familiarity with the choice of imaging techniques and the variety of imaging patterns and treatment options should help guide radiologists in the management of this rare but important subgroup of head and neck neoplasms.
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Affiliation(s)
- Navaraj Subedi
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Said-Al-Naief N, Sciandra K, Gnepp DR. Moderately differentiated neuroendocrine carcinoma (atypical carcinoid) of the parotid gland: report of three cases with contemporary review of salivary neuroendocrine carcinomas. Head Neck Pathol 2013; 7:295-303. [PMID: 23456649 PMCID: PMC3738763 DOI: 10.1007/s12105-013-0431-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/16/2013] [Indexed: 01/07/2023]
Abstract
Primary neuroendocrine carcinomas (NECs) of the salivary glands are rare. Most reported NECs in that region are small cell carcinomas with few cases of large cell undifferentiated carcinoma and typical carcinoid tumors. Only two moderately differentiated NECs (atypical carcinoid tumors) have been previously reported. In the current series, the authors report three additional moderately differentiated NECs (atypical carcinoid tumors) of the parotid gland; two occurred in women and one in a man. All patients were initially treated with parotidectomy, with selective lymph node excision in one, and radiation therapy in another. Follow-up was available for two cases (18 and 79 months). One patient had two local recurrences, developing lymph node and liver metastases requiring further surgery and chemotherapy. Currently, she is alive with disease, on supportive care. The second patient is alive with no signs of recurrence. Patients' work-up excluded the possibility of metastatic NECs to the salivary glands in all cases. Histologically, the tumors demonstrated infiltrating nests, cords and trabeculae of round, oval to spindle shaped cells with moderate to focally abundant eosinophilic cytoplasm, small to prominent nucleoli and chromatin stippling. Scattered rosette-like structures were prominent in one tumor. The highest mitotic counts for the three tumors ranged from 5 to 8 mitotic figures/10 hpfs. Necrosis, focal but distinct, was noted in two tumors, vascular invasion in two tumors and perineural invasion in one tumor. Immunohistochemical staining was diagnostic of neuroendocrine carcinoma, showing uniform positive labeling with broad-spectrum cytokeratin (with a paranuclear punctuate pattern in one case), chromogranin and synaptophysin antibodies. CK20 was negative in two tumors and stained rare cells (<1%) in the third.
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Affiliation(s)
- Nasser Said-Al-Naief
- />Oral and Maxillofacial Pathology Laboratory and Clinical Oral Pathology and Medicine, University of the Pacific, San Francisco, CA USA
| | - Katherine Sciandra
- />Anatomic Pathology and Cytology, VA Medical Center, University of New Mexico School of Medicine, Albuquerque, NM USA
| | - Douglas R. Gnepp
- />Department of Pathology, Warren Albert School of Medicine, Rhode Island Hospital, Brown University Providence, APC 12, 593 Eddy Street, Providence, RI 02903 USA
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The importance of histological types for treatment and prognosis in laryngeal cancer. Eur Arch Otorhinolaryngol 2013; 270:401-3. [PMID: 23315201 DOI: 10.1007/s00405-012-2343-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2012] [Indexed: 12/13/2022]
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Kusafuka K, Abe M, Iida Y, Onitsuka T, Fuke T, Asano R, Kamijo T, Nakajima T. Mucosal large cell neuroendocrine carcinoma of the head and neck regions in Japanese patients: a distinct clinicopathological entity. J Clin Pathol 2012; 65:704-9. [PMID: 22718848 PMCID: PMC3410299 DOI: 10.1136/jclinpath-2012-200801] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Backgrounds Large cell neuroendocrine carcinoma (LCNEC) is well-known as a lung cancer subtype. This study assessed the prevalence of head and neck mucosal LCNEC (M-LCNEC). Methods M-LCNEC was studied clinically, histologically and immunohistochemically. Results Of 814 surgically resected cases of mucosal head and neck carcinoma, only eight cases (0.98%; all men, mean age 64.6 years) were rediagnosed as M-LCNEC. They occurred in the oropharynx (n=3), larynx (n=4) and hypopharynx (n=1). Seven of the cases had regional lymph node metastases and four resulted in death. Histologically, M-LCNEC had a sheet-like trabacular organoid growth pattern of relatively large basaloid cells in which central necrosis, rosette formation, peripheral palisading and high mitotic figures were evident. M-LCNEC was immunopositive for two or three neuroendocrine markers (CD56, chromogranin-A and synaptophysin). All cases showed high proliferative activity. Conclusion M-LCNEC in the head and neck regions is a distinct histopathological entity whose positivity for neuroendocrine markers makes its diagnosis important. As about half of the patients died of the disease, M-LCNEC has a relatively poor prognosis.
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Affiliation(s)
- Kimihide Kusafuka
- Pathology Division, Shizuoka Cancer Center Hospital and Research Institute, Shizuoka, Japan.
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