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Kharrat G, Ferchichi S, Azaiez A, Ferjani M, Chalbi E, Marrakchi J. Agressive small cell neuroendocrine carcinoma of the neck: A case report. Int J Surg Case Rep 2024; 124:110341. [PMID: 39326373 DOI: 10.1016/j.ijscr.2024.110341] [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: 08/25/2024] [Revised: 09/18/2024] [Accepted: 09/21/2024] [Indexed: 09/28/2024] Open
Abstract
INTRODUCTION The location in the neck of small cell neuroendocrine carcinoma (SCNEC) is rare and aggressive with a poor prognosis. We herein describe an extremely uncommon example of cervical SCNEC probably arising in the parotid gland, diagnosed at an advanced metastatic stage. PRESENTATION OF CASE A 76 year old man, non-smoking, non-alcoholic presented a left cervical and rapidly progressive mass. It was suspicious of malignancy and located in the parotid space and II, III, IV and V lymph node groups. In two weeks, the patient had presented a rapid increase in size, with extensive skin permeation. CT scan revealed a large mass infiltrating the left parotid and submandibular glands compressing the jugulo-carotid vascular axis and liver metastases. Diagnosis was made on the morphological pathological examination supplemented by the immunohistochemistry examination, indeed, cells were immunoreactive for chromogranin A as well as synaptophysin. Chemotherapy based on cisplatin and Etoposide VP 16 was started but the evolution was unfavorable: death occurred after 2 cycles. CLINICAL DISCUSSION Neuroendocrine neoplasm arises from neural crest cells. Its location in the head and neck is extremely rare with a tendency for aggressive local invasion and a strong propensity for both regional and distant metastasis. Treatment may include surgical resection, radiotherapy, chemotherapy, or combination of these modalities. The prognosis is poor. CONCLUSION The clinician must discuss the diagnosis of cervical SCNEC when faced with a man in the seventh decade who presents an agressive rapidly expanding cervical mass. The diagnosis confirmation is pathological combining morphological and immunohistochemical evaluations.
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Affiliation(s)
- G Kharrat
- ENT department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine, El Manar University of Tunis, Tunisia.
| | - S Ferchichi
- ENT department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine, El Manar University of Tunis, Tunisia
| | - A Azaiez
- ENT department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine, El Manar University of Tunis, Tunisia
| | - M Ferjani
- ENT department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine, El Manar University of Tunis, Tunisia
| | - E Chalbi
- Pathology department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine, El Manar University of Tunis, Tunisia
| | - J Marrakchi
- Regional hospital of Menzel Bourguiba, Faculty of Medicine, El Manar University of Tunis, Tunisia
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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] [MESH Headings] [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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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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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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Shi X, Huang X, Wang K, Qu Y, Chen X, Wu R, Zhang Y, Zhang J, Luo J, Wang J, Yi J. Long-term outcomes and prognosis of neuroendocrine neoplasms of the head and neck: a cohort from a single institution. J Cancer Res Clin Oncol 2024; 150:288. [PMID: 38834932 PMCID: PMC11150319 DOI: 10.1007/s00432-024-05726-1] [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: 03/05/2024] [Accepted: 03/25/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Neuroendocrine neoplasm is a rare cancer of head and neck. This study aimed to evaluate clinical features, treatment outcomes, and prognostic factors of neuroendocrine neoplasm of head and neck treated at a single institution. METHODS Between Nov 2000 and Nov 2021, ninety-three patients diagnosed with neuroendocrine neoplasms of head and neck treated at our institution were reviewed retrospectively. The initial treatments included chemotherapy (induction, adjuvant, or concurrent) combined with radiotherapy in 40 patients (C + RT group), surgery followed by post-operative RT in 34 (S + RT group), and surgery plus salvage therapy in 19 patients (S + Sa group). RESULTS The median follow-up time was 64.5 months. 5-year overall survival rate (OS), progression-free survival rate (PFS), loco-regional relapse-free survival free rate (LRRFS) and distant metastasis-free survival rate (DMFS) were 64.5%, 51.6%, 66.6%, and 62.1%, respectively. For stage I-II, the 5-year LRRFS for patients' treatment regimen with or without radiotherapy (C + RT and S + RT groups versus S + Sa group) was 75.0% versus 12.7% (p = 0.015) while for stage III-IV, the 5-year LRRFS was 77.8% versus 50.0% (p = 0.006). The 5-year DMFS values for patients with or without systemic therapy (C + RT group versus S + RT or S + Sa) were 71.2% and 51.5% (p = 0.075). 44 patients (47.3%) experienced treatment failure and distant metastasis was the main failure pattern. CONCLUSIONS Radiotherapy improved local-regional control and played an important role in the management of HNNENs. The optimal treatment regimen for HNNENs remains the combination of local and systemic treatments.
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Affiliation(s)
- Xinqi Shi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences (CAMS), Langfang, China.
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6
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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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Nakamura N, Sakagami T, Suzuki K, Takahashi Y, Noda Y, Tsuta K, Naganuma M. Successful endoscopic resection for well-differentiated neuroendocrine tumor, Grade 1, in the hypopharynx. Clin J Gastroenterol 2024; 17:80-83. [PMID: 37919638 DOI: 10.1007/s12328-023-01877-9] [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: 07/21/2023] [Accepted: 10/07/2023] [Indexed: 11/04/2023]
Abstract
Well-differentiated neuroendocrine tumor, Grade 1 (NET, G1), in the hypopharynx is extremely rare. A 62-year-old woman was referred to our clinic with a tumor in the postcricoid area. The tumor was diagnosed NET on biopsy and there were no metastatic findings on CT, therefore we performed endoscopic resection. Histologic examination revealed well-differentiated neuroendocrine tumor, Grade 1. This case was an extremely rare and valuable case in which endoscopic images can be observed in detail. Endoscopic resection was performed and successful endoscopic and histological resection was achieved.
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Affiliation(s)
- Naohiro Nakamura
- Third Department of Internal Medicine, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan.
| | - Tomofumi Sakagami
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Kensuke Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Yu Takahashi
- Third Department of Internal Medicine, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Yuri Noda
- Department of Pathology, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Koji Tsuta
- Department of Pathology, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Makoto Naganuma
- Third Department of Internal Medicine, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
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8
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Baruah RM, Ghosh A, Baishya S. Sinonasal Neuroendocrine Carcinoma: A Case report. Indian J Otolaryngol Head Neck Surg 2023; 75:4003-4006. [PMID: 37974789 PMCID: PMC10645772 DOI: 10.1007/s12070-023-04026-3] [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: 02/19/2023] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
Neuroendocrine carcinoma are rare tumor which begin in specialized cells called neuroendocrine cells. It can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas. We reported a case of sinonasal neuroendocrine carcinoma in a 65 year old lady who had presented with a history of right nasal obstruction, bloody nasal discharge, and recurrent epistaxis. On examination, a red, friable, polypoid mass with a tendency to bleed was seen in the right nasal cavity. Computed tomography revealed there was a enhancing expansile necrotic mass in right nasal cavity abutting the medial nasal wall. There was presence of mucosal thickening with inspissated secretion in all sinuses except left maxillary sinus. The patient underwent endoscopic removal of the tumour. Biopsy revealed poorly differentiated carcinoma of right nasal cavity. Immunohistochemistry revealed small cell neuroendocrine carcinoma. After that, the patient had postoperative external radiation treatment with a 6600 cGy dosage administered over 33 fractions. The patient had routine follow-up at the radiation oncology and otolaryngology outpatient departments throughout a 12-month period. During the postoperative month-to-month follow-up, there was no evidence of a local tumour recurrence in the endoscopy.
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Affiliation(s)
| | - Avinava Ghosh
- Guwahati Ear and Sinus Center, Chikitsa Clinic, Assam Trunk Rd, Adabari Tiniali, Pandu, Guwahati, Assam 781012 India
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Selesky M, Elghawy O, Kaur V. Improved survival for stage IV sinonasal small cell neuroendocrine carcinoma treated with chemotherapy and anti-PD-L1 therapy. BMJ Case Rep 2023; 16:e255313. [PMID: 37977842 PMCID: PMC10660969 DOI: 10.1136/bcr-2023-255313] [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: 11/19/2023] Open
Abstract
Small cell carcinoma neuroendocrine type (SCCNET) is a rare tumour of the head and neck. Due to its infrequency, a paucity of data exists on optimal treatment, and the current paradigm for advanced SCCNET mirrors that of extensive small cell lung cancer. Increasingly, the treatment for extrapulmonary small cell carcinomas like SCCNET has incorporated immune checkpoint inhibitors (ICIs), although the utility of ICIs is not fully understood. We present a case of stage IVC sinonasal SCCNET in a woman in her 90s, who experienced eyelid swelling and unintentional weight loss. After diagnostic work-up, she was treated with etoposide, carboplatin and atezolizumab with a complete response to therapy. The patient had one episode of inflammatory polyarthropathy which resolved with steroids but otherwise tolerated treatment well and is now living with an overall survival of greater than 27 months. This case highlights the long-term efficacy of combination ICIs and chemotherapy in the treatment of SCCNET.
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Affiliation(s)
- Margaret Selesky
- Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA
| | - Omar Elghawy
- Department of Internal Medicine, division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Varinder Kaur
- Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA
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10
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Kamarudin Z, Jamaluddin N, Latar NHM, Pauzi SHM, Muhammad R. Neuroendocrine carcinoma of tonsil presented with axillary lymph node metastasis: Management dilemma. J Cancer Res Ther 2023; 19:2104-2107. [PMID: 38376332 DOI: 10.4103/jcrt.jcrt_1506_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/11/2021] [Indexed: 02/21/2024]
Abstract
ABSTRACT High-grade neuroendocrine carcinoma (NEC) of the tonsil is rare and has a poor prognosis. The usual presentation is a neck mass with locoregional cervical lymphadenopathy. An axillary lymphadenopathy as a primary presentation of NEC of the tonsils is uncommon and challenging to treat. Tonsil neuroendocrine tumors display aggressive behaviors associated with early recurrence and metastasis after surgical resection. Managing this condition is demanding compared to NECs of gastrointestinal origin since, to date, the management of head-and-neck neuroendocrine tumors is still not well established. We present a 49-year-old female with a rare case of NEC of the tonsil presenting primarily with axillary lymph nodes metastasis. The patient's axillary lymph node was biopsied and revealed a Grade III neuroendocrine tumor. A positron emission tomography (PET) scan was done in searching of a primary lesion and showed a highly metabolic mass of the left tonsil as well as a left axillary lymph node suggestive of metastasis. The patient has been managed with a multimodality approach, with a combination of chemotherapy regimen and surgical resection of the axillary lymph node. Subsequent PET scan evaluation showed a complete response of the primary tumor with residual left axillary lymph node metastasis. NECs of tonsil presented with axillary lymph nodes metastasis is rare and has a poor prognostic outcome. It poses a dilemma with regard to management, as surgical resection of the metastasis is not promising given the possibility of early recurrence.
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Affiliation(s)
- Zalikha Kamarudin
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Nadia Jamaluddin
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Nani Harlina Md Latar
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Suria Hayati Md Pauzi
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Rohaizak Muhammad
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
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Becht R, Kiełbowski K, Żychowska J, Dembowska W, Król M, Birkenfeld B, Owsiak M, Lewandowska M, Kubrak J, Amernik K. Small cell carcinoma with neuroendocrine differentiation of subglottic larynx- a case report. Front Oncol 2023; 13:1222418. [PMID: 37817765 PMCID: PMC10560848 DOI: 10.3389/fonc.2023.1222418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/25/2023] [Indexed: 10/12/2023] Open
Abstract
Small cell cancer (SCC) is a neuroendocrine neoplasm, which is most frequently found in the lungs. Extrapulmonary location of SCC is rare and may involve 2.5-5% of SCCs. We present a case of a 31-year-old male patient with an extremely uncommon subglottic SCC. The patient was qualified for a radical sequential chemoradiotherapy. After treatment, patient's condition suggested complete remission. Recurrence was detected one year later, and the disease rapidly progressed, despite a second line chemotherapy. The patient died 29 months after initial diagnosis. This case aims to raise awareness on the aggressive laryngeal SCC and its good response to first line chemotherapy composed of cisplatin and etoposide, followed by radiotherapy.
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Affiliation(s)
- Rafał Becht
- Department of Clinical Oncology, Chemotherapy and Cancer Immunotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Kajetan Kiełbowski
- Department of Clinical Oncology, Chemotherapy and Cancer Immunotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Justyna Żychowska
- Department of Clinical Oncology, Chemotherapy and Cancer Immunotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Wiktoria Dembowska
- Department of Clinical Oncology, Chemotherapy and Cancer Immunotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Małgorzata Król
- Department of Clinical Oncology, Chemotherapy and Cancer Immunotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Bożena Birkenfeld
- Department of Nuclear Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Mateusz Owsiak
- Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University, Szczecin, Poland
| | | | - Jadwiga Kubrak
- Department of Clinical Radiotherapy, West Pomeranian Oncology Center, Szczecin, Poland
| | - Katarzyna Amernik
- Department of Adult and Children Otolaryngology and Otolaryngological Oncology, Pomeranian Medical University, Szczecin, Poland
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12
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Chiesa-Estomba CM, Barillari MR, Mayo-Yáñez M, Maniaci A, Fakhry N, Cammaroto G, Ayad T, Lechien JR. Non-Squamous Cell Carcinoma of the Larynx: A State-of-the-Art Review. J Pers Med 2023; 13:1084. [PMID: 37511697 PMCID: PMC10381862 DOI: 10.3390/jpm13071084] [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: 05/18/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Non-squamous cell laryngeal carcinoma includes endothelial tumors, such as minor salivary gland tumors, lymphoepithelial tumors, neuroendocrine tumors, soft and hard tissue sarcomas, and malignant melanomas. (2) Methods: A state-of-the-art review using the MEDLINE/PUBMED, Google Scholar, Ovid Medline, Embase, and Scopus electronic databases was performed. (3) Conclusions: In order to optimize overall treatment outcomes, a multidisciplinary, patient-centered approach to the management of non-SCC of the larynx must be adopted universally; a national or international registry on non-SCC laryngeal cancer can be useful to improve understanding about the behavior of this kind of tumor.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Donostia University Hospital, Osakidetza, 20014 San Sebastian, Spain
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
| | - Maria Rosaria Barillari
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, 81100 Naples, Italy
| | - Miguel Mayo-Yáñez
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Antonino Maniaci
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Via S. Sofia 78, 95125 Catania, Italy
| | - Nicolas Fakhry
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otorhinolaryngology-Head and Neck Surgery, APHM, La Conception University Hospital, 13005 Marseille, France
| | - Giovanni Cammaroto
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Morgagni Pierantoni Hospital, 47100 Forli, Italy
| | - Tareck Ayad
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Otolaryngology-Head & Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Jerome R Lechien
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France
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13
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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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14
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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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15
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Agrawal S, Deora A, Sen S, Gupta S, Das D. Small cell neuroendocrine carcinoma with primary orbital involvement - The unseen, and a review of literature. INDIAN J PATHOL MICR 2023; 66:155-158. [PMID: 36656229 DOI: 10.4103/ijpm.ijpm_1144_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Neuroendocrine neoplasms are derived from the epithelial lineages mainly of respiratory tract, with predominant neuroendocrine differentiation. There are only a handful of documented cases of paranasal small cell neuroendocrine carcinomas (SNEC) with primary orbital involvement. Here, the authors describe a 33-year-old male patient with rapidly progressive swelling of the right lower lid with proptosis since 4 weeks. On contrast-MRI orbit, an ill-defined multilobulated mass measuring 3.6 × 3.1 cm with intense homogenous enhancement was seen in the right retrobulbar space involving the right ethmoid sinus. On incisional biopsy, a poorly differentiated mass containing numerous small round blue cells and scanty intervening stroma with prominent necrosis and apoptosis was seen. Immunohistochemistry was strongly positive for synaptophysin. He was diagnosed as a case of SNEC and received chemotherapy, with good response till date of 9 months of follow up. The authors present a literature review and describe challenges in management of a primary orbital SNEC.
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Affiliation(s)
- Sahil Agrawal
- Oculoplasty and Paediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Aarush Deora
- Oculoplasty and Paediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Seema Sen
- Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Saloni Gupta
- Department of Ophthalmology, Northern Railway Central Hospital, New Delhi, India
| | - Deepsekhar Das
- Oculoplasty and Paediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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16
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A rare localization of small-cell carcinoma in head and neck area: case report. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [DOI: 10.1186/s43163-022-00337-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Small-cell carcinoma (SMCC) of hypopharynx is an extreme rare entity in the head and neck region. It is commonly arising from pulmonary in origin. We report a rare case of small-cell carcinoma of hypopharynx that caused upper airway obstruction in an elderly gentleman.
Case presentation
A 67-year-old man is presented to otorhinolaryngology clinic with a 4-month history of worsening shortness of breath and stridor. He was heavy tobacco smoker for 60 pack-years. Flexible nasopharyngolaryngoscopy revealed a large mass at the right pyriform fossa extending superiorly and obstructing the laryngeal inlet. He underwent tracheostomy, examination under general anesthesia with tissue biopsy. Histology from tissue biopsy revealed small-cell carcinoma. The positron emission tomography-CT showed exophytic mass from right pyriform sinus with regional and lung pleural metastasis as well. There was the absence of formal staging system for SMCC due to its limited and rare incidence. He was treated with combination of carboplatin and etoposide, similar to the regime for cell carcinoma of lung. The tumor regressed loco-regionally, and his pleural metastasis had shrunk to sub-centimeter in size.
Conclusions
To date, there is very limited data available on head and neck small cell carcinomas to guide treatment recommendations as well as staging system. Paucity of clinical data and outcome about this rare malignancy makes this report a valuable piece of experience to be shared together with existing literature.
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17
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Matsuyama H, Ueki Y, Okamoto I, Nagao T, Honda K, Yamazaki K, Okabe R, Togashi T, Shodo R, Ota H, Takahashi T, Omata J, Yokoyama Y, Saijo K, Tanaka R, Tsukahara K, Kitahara T, Uemura H, Yoshimoto S, Matsumoto F, Okami K, Sakai A, Takano K, Kondo A, Inohara H, Eguchi H, Oridate N, Tanabe T, Nakamizo M, Yokoshima K, Miura K, Kitani Y, Horii A. Head and neck small-cell carcinoma: A multicenter study of 39 cases from 10 institutions. Front Surg 2022; 9:1049116. [DOI: 10.3389/fsurg.2022.1049116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/05/2022] [Indexed: 11/15/2022] Open
Abstract
ObjectiveBasal information of head and neck small-cell carcinoma (HNSmCC) including epidemiology, primary site, treatment, and prognosis remains sparse due to its rarity. We report here a multicenter retrospective study on the diagnosis, treatment, and outcomes of patients with HNSmCC.Materials and methodsThis study involved 47 patients with HNSmCC from 10 participating institutions. Eight patients were excluded for whom no pathological specimens were available (n = 2) and for discrepant central pathological judgements (n = 6). The remaining 39 patients were processed for data analysis.ResultsAs pretreatment examinations, computed tomography (CT) was performed for the brain (n = 8), neck (n = 39), and chest (n = 32), magnetic resonance imaging (MRI) for the brain (n = 4) and neck (n = 23), positron emission tomography-CT (PET-CT) in 23 patients, bone scintigraphy in 4, neck ultrasonography in 9, and tumor markers in 25. Primary sites were oral cavity (n = 1), nasal cavity/paranasal sinuses (n = 16), nasopharynx (n = 2), oropharynx (n = 4), hypopharynx (n = 2), larynx (n = 6), salivary gland (n = 3), thyroid (n = 2), and others (n = 3). Stages were II/III/IV-A/IV-B/IV-C/Not determined = 3/5/16/6/5/4; stage IV comprised 69%. No patient had brain metastases. First-line treatments were divided into 3 groups: the chemoradiotherapy (CRT) group (n = 27), non-CRT group (n = 8), and best supportive care group (n = 4). The CRT group included concurrent CRT (CCRT) (n = 17), chemotherapy (Chemo) followed by radiotherapy (RT) (n = 5), and surgery (Surg) followed by CCRT (n = 5). The non-CRT group included Surg followed by RT (n = 2), Surg followed by Chemo (n = 1), RT alone (n = 2), and Chemo alone (n = 3). The 1-year/2-year overall survival (OS) of all 39 patients was 65.3/53.3%. The 1-year OS of the CRT group (77.6%) was significantly better compared with the non-CRT group (31.3%). There were no significant differences in adverse events between the CCRT group (n = 22) and the Chemo without concurrent RT group (n = 9).ConclusionNeck and chest CT, neck MRI, and PET-CT would be necessary and sufficient examinations in the diagnostic set up for HNSmCC. CCRT may be recommended as the first-line treatment. The 1-year/2-year OS was 65.3%/53.3%. This study would provide basal data for a proposing the diagnostic and treatment algorithms for HNSmCC.
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18
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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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19
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Raposo A, Martínez-Ortiz MJ, Buendía A, Guillén E, Bermúdez C, García-Purriños F. Complete remission of stage IV sinonasal small cell neuroendocrine carcinoma: A case report. Mol Clin Oncol 2022; 16:48. [PMID: 35003746 DOI: 10.3892/mco.2021.2481] [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: 08/03/2021] [Accepted: 09/30/2021] [Indexed: 11/06/2022] Open
Abstract
Sinonasal small cell carcinoma (SmCC) is a rare type of neoplasm. The current case report describes the case of a 30-year-old male patient with stage IV SmCC who underwent concurrent radiotherapy (RT) plus etoposide-cisplatin treatment. Positron emission tomography (PET)/computed tomography (CT) and fibroscopy examination showed complete remission at 3 months post-treatment. However, leptomeningeal metastasis (LM) occurred at 9 months. A literature search identified no previous case reports describing LM of SmCC. The patient was treated with concurrent RT plus irinotecan-gemcitabine. During the sixth cycle of irinotecan-gemcitabine, the patient required intensive care admission due to severe acute respiratory syndrome-related coronavirus 2-associated pneumonia. Following clearance of the pneumonia, LM was assessed using PET/CT and MRI at 3 months, which revealed a complete response to irinotecan-gemcitabine. In May 2021, the patient succumbed to LM following disease recurrence. The findings of this case report should encourage other authors to publish their treatment outcomes regarding SmCC. More clinical trials are required to achieve better results in terms of patient outcome.
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Affiliation(s)
- Alberto Raposo
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Los Arcos del Mar Menor, San Javier, 30739 Murcia, Spain
| | | | - Ana Buendía
- Department of Anatomical Pathology, Hospital Universitario Los Arcos del Mar Menor, San Javier, 30739 Murcia, Spain
| | - Elena Guillén
- Department of Anatomic Pathology, Hospital Universitario Santa Lucia, Cartagena, 30202 Murcia, Spain
| | - Cristina Bermúdez
- Department of Radiology, Hospital Universitario Los Arcos del Mar Menor, San Javier, 30739 Murcia, Spain
| | - Francisco García-Purriños
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Los Arcos del Mar Menor, San Javier, 30739 Murcia, Spain
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20
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Amjad MM, Jacobs SM, Callahan MA, Gonzalez ML, Tavakoli M. Small Cell Neuroendocrine Carcinoma Presenting as Recurrent Dacryocystitis: Case Report of a Rare Entity. Ophthalmic Plast Reconstr Surg 2022; 38:e2-e6. [PMID: 34431823 DOI: 10.1097/iop.0000000000002052] [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: 11/25/2022]
Abstract
An 84-year-old man presented with a localized, firm, tender mass over the right lacrimal sac. He had a history of acute dacryocystitis in the same eye 6 months before presentation, which resolved with antibiotics followed by uneventful dacryocystorhinostomy. At repeat presentation, the patient underwent orbital imaging and excisional biopsy of the lesion. Histologic studies revealed a small cell neuroendocrine carcinoma. The patient was subsequently treated with chemotherapy and radiation. Although there are rare reports of small cell neuroendocrine carcinoma originating in the sino-orbital-lacrimal region, this is the first report of tumor presentation with acute dacryocystitis in a patient with prior dacryocystorhinostomy.
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Affiliation(s)
- Muhammad M Amjad
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Sarah M Jacobs
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Michael A Callahan
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Manuel Lora Gonzalez
- Department of Pathology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, U.S.A
| | - Mehdi Tavakoli
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
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21
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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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22
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Liu Y, Mi Y, Zhang L, Jiang T. Survival and risk factors of adenosquamous carcinoma in the oral and maxillofacial region: a population-based study. Am J Transl Res 2021; 13:12071-12082. [PMID: 34786144 PMCID: PMC8581841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The features and prognosis of adenosquamous carcinoma (ASC) in oral and maxillofacial region have not thoroughly investigated, the purpose of this study is to describe clinicopathologic characteristics, treatment, and prognostic factors of this disease. METHODS The data of 276 patients diagnosed with ASC in oral and maxillofacial region between 1975 and 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The prognostic factors influencing overall survival (OS) and disease-specific survival (DSS) were identified by the Kaplan-Meier analysis and Cox regression analysis. The nomograms for OS and DSS were constructed to predict the prognosis of these patients. RESULTS Of 276 included patients, 62.7% were male and 37.3% were female, with an average age at diagnosis of 63.5 years. The most common primary site is oral cavity (170/276), followed by salivary gland (106/276). The 3-, and 5-year OS of patients with ASC in oral and maxillofacial region were 49.0% and 38.9%, while the 3-, and 5-year DSS were 67.7%, and 60.4%, respectively. Patients who underwent surgery had longer OS (mOS: 58 m vs. 8 m) and DSS (mDSS: 193 m vs. 18 m) than those who did not. Age, AJCC-T/N/M category as well as surgery were independently associated with OS. Advanced T stage, distant metastases, and surgery were independent factors for DSS. The prognostic nomograms for OS and DSS were constructed, and the C-indexes were 0.71 (95% CI 0.66-0.76) and 0.76 (95% CI 0.67-0.85), respectively. CONCLUSION Surgery was the favorable prognostic factor for both OS and DSS among patients with ASC in oral and maxillofacial region.
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Affiliation(s)
- Ying Liu
- Center for Esthetic Dentistry, Jinan Stomatological HospitalJinan 250001, China
| | - Yong Mi
- Dental Laboratory, Jinan Stomatological HospitalJinan 250001, China
| | - Li Zhang
- Center for Esthetic Dentistry, Jinan Stomatological HospitalJinan 250001, China
| | - Tao Jiang
- Center for Esthetic Dentistry, Jinan Stomatological HospitalJinan 250001, China
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23
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Fiorini FR, Abbas Y, Mukhopadhyay S, Tatla T. Surgical palliation in poorly differentiated neuroendocrine carcinoma of the hypopharynx: Case report. Cancer Rep (Hoboken) 2021; 5:e1558. [PMID: 34609069 PMCID: PMC9351644 DOI: 10.1002/cnr2.1558] [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: 06/06/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Primary neuroendocrine carcinomas (NECs) are very rare entities accounting for 0.49% of all malignancies. Within the head and neck, the most common sites are the larynx and paranasal sinuses, while the hypopharynx is seldom described. Case We present a patient with a poorly differentiated metastatic NEC of the hypopharynx treated palliatively with organ‐preserving surgery and post‐operative chemotherapy, and literature review for well‐documented pure hypopharyngeal NECs. Our patient died of chest infection during chemotherapy, 4 months after surgery. Conclusion Chemotherapy remains the mainstay of treatment in the presence of metastases with 2‐year overall survival of 15.7%. Due to the aggressive nature of poorly differentiated metastatic NECs, surgical management is seldom considered. We report and advocate the successful palliative role of organ‐preserving, minimally invasive trans‐oral LASER micro‐surgery and neck dissection to control loco‐regional head and neck disease, safe‐guarding better quality of home life, despite limited life expectancy for this condition.
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Affiliation(s)
| | - Yasmin Abbas
- Departmentof Otolaryngology and Head and Neck, Northwick Park Hospital, London, UK
| | - Suchana Mukhopadhyay
- Departmentof Otolaryngology and Head and Neck, Northwick Park Hospital, London, UK
| | - Taran Tatla
- Departmentof Otolaryngology and Head and Neck, Northwick Park Hospital, London, UK
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24
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Neuroendocrine Carcinoma of the Larynx and Pharynx: A Clinical and Histopathological Study. Cancers (Basel) 2021; 13:cancers13194813. [PMID: 34638312 PMCID: PMC8507659 DOI: 10.3390/cancers13194813] [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] [Received: 08/09/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Neuroendocrine carcinomas (NECs) of the head and neck are rare. The presented series of 20 patients with laryngeal and pharyngeal NECs is population-based and one of the largest published to date. We analyzed the treatment results according to the type of therapy and the role of various standard (synaptophysin-chromogranin-CD56, Ki-67, p16, HPV, and EBV) and some novel (INSM1 and PD-L1) neuroendocrine markers or potential prognosticators. The results indicate the following: (1) laryngeal and pharyngeal NECs accounted for 0.43% and 0.17% of the cases in the corresponding tumor groups, respectively; (2) neuroendocrine differentiation can be reliably determined by INSM1 immunohistochemistry; (3) the prognosis was determined by the nodal stage and TNM stage but not by the histological grade (which refers to moderately and poorly differentiated NECs); (4) except in well-differentiated NECs and early-stage (T1-2N0-1) moderately/poorly differentiated NECs, aggressive multimodal therapy is needed; and (5) the p16, HPV, and EBV statuses failed to show any prognostic value. Abstract Neuroendocrine carcinomas (NECs) of the head and neck are rare and the experience scanty. The Cancer Registry of Slovenia database was used to identify cases of laryngeal and pharyngeal NECs diagnosed between 1995–2020. Biopsies were analyzed for the expression of standard neuroendocrine markers (synaptophysin, chromogranin, CD56), INSM1, Ki-67, p16, and PD-L1 (using the combined positive score, CPS). In situ hybridization for human papillomavirus (HPV) and Epstein–Barr virus (EBV) was performed. Twenty patients (larynx, 12; pharynx, 8) were identified. One tumor was well differentiated (WD), five were moderately differentiated (MD), and 14 were poorly differentiated (PD). Disease control was achieved solely by surgery in 4/4 MD/PD T1-2N0-1 tumors. Eight patients died of the disease, seven of which were due to distant metastases. All three traditional markers were positive in 11/17 NECs and the INSM1 marker in all 20 tumors. Two of fourteen p16-positive tumors were HPV-positive, but all three nasopharyngeal NECs were EBV-negative. Three tumors had CPSs ≥ 1. In conclusion, INSM1 was confirmed to be a reliable marker of neuroendocrine differentiation. Except in WD and early-stage MD/PD tumors, aggressive multimodal therapy is needed; the optimal systemic therapy remains to be determined. p16, HPV, and EBV seem to bear no prognostic information.
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25
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Chen LY, Chang SL, Lee WY. Primary small cell neuroendocrine carcinoma in the nasal cavity: A CARE-compliant case report. Medicine (Baltimore) 2021; 100:e27136. [PMID: 34477164 PMCID: PMC8415994 DOI: 10.1097/md.0000000000027136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/18/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses is a rare but aggressive neoplasm with a poor prognosis and a strong propensity for regional recurrence and distant metastasis. Diagnosis is challenging and relies on immunohistochemical study. Treatment includes surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. However, the optimal therapeutic strategy is still controversial. Due to its rarity, the complexity of the histological diagnosis, and the variety of the treatment regimens, we presented a case of primary small cell neuroendocrine carcinoma in the nasal cavity with description of the clinical manifestation, pathology features, and our treatment regimen. PATIENT CONCERNS An 82-year-old female patient with hypertension presented with right epistaxis on and off with nasal obstruction for several days. DIAGNOSIS An exophytic mass over the posterior end of the right inferior turbinate was found on nasopharyngoscope. Biopsy was done and the pathology confirmed small cell carcinoma, strongly positive for cytokeratin (AE1/AE3) and insulinoma-associated protein 1 (INSM-1), scatteredly positive for chromogranin A, synaptophysin and CD56. The final diagnosis was small cell neuroendocrine carcinoma of right nasal cavity, pT1N0M0, stage I. INTERVENTIONS The patient underwent wide excision of right intra-nasal tumor and post-operative radiotherapy with a dose of 6600 cGy in 33 fractions. OUTCOMES No local recurrence or distant metastasis was noted during the 12 months of follow-up. LESSONS Multimodality treatment remains the most common therapeutic strategy, although no proven algorithm has been established due to the rarity of this disease. Further investigation is needed for providing evidence to standardize the treatment protocol.
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Affiliation(s)
- Li-Yu Chen
- Department of Otorhinolaryngology, Chi Mei Medical Center, Tainan, Taiwan
| | - Shih-Lun Chang
- Department of Otorhinolaryngology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Wen-Ying Lee
- Department of Cytopathology, Chi Mei Medical Center, Tainan, Taiwan
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26
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Kim D, Kim S, Pak MG, Bae WY. A Case of Small Cell Carcinoma Originated from Sphenoid Sinus in Patient with Recurrent Pituitary Tumor. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2021.00351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Small cell carcinoma (SmCC) is a type of neuroendocrine tumor commonly originating in the lung, with only about 2-4% of cases arising at extrapulmonary sites. Extrapulmonary SmCC of the head and neck has a poor prognosis and a high rate of distant metastasis. The paranasal sinus is a rare location for extrapulmonary SmCC and only a few related papers have been published to date. We report a rare case of SmCC originating from the sphenoid sinus in a patient with a recurrent pituitary tumor with a literature review.
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27
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Chen M, Wu S, He Z, Cheng Z, Duan S, Jiang H, Wang G. Apatinib combined with concurrent chemoradiotherapy in patients with subglottic small cell carcinoma: a case report. J Int Med Res 2021; 49:3000605211016146. [PMID: 34038201 PMCID: PMC8161863 DOI: 10.1177/03000605211016146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/08/2021] [Indexed: 12/28/2022] Open
Abstract
Subglottic small cell carcinoma (SSMCC) is a rare type of neoplasm, meaning that laryngeal cancer guidelines in several countries, including the National Comprehensive Cancer Network (NCCN) guidelines, do not include treatment principles for SSMCC. Angiogenesis is an established factor in tumor initiation, growth, and dissemination. Apatinib mesylate, an orally administered drug, is a novel inhibitor of vascular endothelial growth factor receptor-2, a key mediator of angiogenesis, and has been shown to be safe and efficacious in the treatment of certain types of malignant tumors. To the best of our knowledge, there are few reports on the treatment of SSMCC with apatinib combined with concurrent chemoradiotherapy. In the present report of SSMCC in a 64-year-old woman, oral apatinib was given daily at a dose of 250 mg in combination with concurrent chemoradiotherapy; the only toxicities reported were mild leukopenia and finger numbness. Clear and rapid efficacy was observed with the disappearance of the tumor mass. Our findings indicate that apatinib combined with concurrent chemoradiotherapy may be effective in patients with SSMCC, with adverse reactions within the manageable range, thus representing an additional treatment option for this type of malignancy.
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Affiliation(s)
- Man Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Shuang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Zelai He
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Zenong Cheng
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Shimiao Duan
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Hao Jiang
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
| | - Gengming Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
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28
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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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29
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Huang D, Peng Y, Xiong H, Hu X, Wang C, Wang Z, Su T, Huang L. Primary poorly differentiated neuroendocrine carcinoma of the oral cavity. Oral Dis 2021; 28:1811-1815. [PMID: 33694290 DOI: 10.1111/odi.13839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/12/2021] [Accepted: 03/06/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Danni Huang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Ying Peng
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Haofeng Xiong
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Xin Hu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Can Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Zijia Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Tong Su
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
| | - Long Huang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.,Institute of Oral Precancerous Lesions, Central South University, Changsha, China
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30
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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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31
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Mahmood N, Kaya G, Zhang TT, Topple J, Howlett DC. Sonographic appearances of facial lumps in adults with a focus on cheek masses: A pictorial essay. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:175-183. [PMID: 33295669 DOI: 10.1002/jcu.22959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/30/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Nadia Mahmood
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Guven Kaya
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Ting Ting Zhang
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Jane Topple
- Radiology Department, East Sussex University Hospitals Trust, Eastbourne, UK
| | - David C Howlett
- Radiology Department, East Sussex University Hospitals Trust, Eastbourne, UK
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32
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Ohmoto A, Sato Y, Asaka R, Fukuda N, Wang X, Urasaki T, Hayashi N, Sato Y, Nakano K, Yunokawa M, Ono M, Tomomatsu J, Toshiyasu T, Mitani H, Takeuchi K, Mori S, Takahashi S. Clinicopathological and genomic features in patients with head and neck neuroendocrine carcinoma. Mod Pathol 2021; 34:1979-1989. [PMID: 34247193 PMCID: PMC8514330 DOI: 10.1038/s41379-021-00869-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 02/08/2023]
Abstract
Neuroendocrine carcinoma (NEC) of the head and neck is a rare type of malignancy, accounting for only 0.3% of all head and neck cancers, and its clinicopathological and genomic features have not been fully characterized. We conducted a retrospective analysis of 27 patients with poorly differentiated NEC of the head and neck seen at our institution over a period of 15 years. Patient characteristics, adopted therapies, and clinical outcomes were reviewed based on the medical records. Pathological analysis and targeted sequencing of 523 cancer-related genes were performed using evaluable biopsied/resected specimens based on the clinical data. The most common tumor locations were the paranasal sinus (33%) and the oropharynx (19%). Eighty-one percent of the patients had locally advanced disease. The 3-year overall survival rates in all patients and in the 17 patients with locally advanced disease who received multimodal curative treatments were 39% and 53%, respectively. Histologically, large cell neuroendocrine carcinoma was the predominant subtype (58% of evaluable cases), and the Ki-67 labeling index ranged from 59 to 99% (median: 85%). Next-generation sequencing in 14 patients identified pathogenic/likely pathogenic variants in TP53, RB1, PIK3CA-related genes (PREX2, PIK3CA, and PTEN), NOTCH1, and SMARCA4 in six (43%), three (21%), two (14%), two (14%), and one (7%) patients, respectively. Sequencing also detected the FGFR3-TACC3 fusion gene in one patient. The median value of the total mutational burden (TMB) was 7.1/Mb, and three patients had TMB ≥ 10. Regardless of the aggressive pathological features, our data revealed favorable clinical characteristics in the patients with locally advanced disease who received curative treatment. The lower TP53 and RB1 mutation prevalence rates compared to those described for small cell lung cancer suggests the biological heterogeneity of NEC in different parts of the body. Furthermore, the FGFR3-TACC3 fusion gene and mutations in genes encoding the components of the NOTCH and PI3K/AKT/mTOR pathways found in our study may be promising targets for NEC of the head and neck.
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Affiliation(s)
- Akihiro Ohmoto
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yukiko Sato
- grid.410807.a0000 0001 0037 4131Division of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Reimi Asaka
- grid.410807.a0000 0001 0037 4131Division of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan ,grid.410807.a0000 0001 0037 4131Pathology Project for Molecular Targets, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoki Fukuda
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Xiaofei Wang
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetsuya Urasaki
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naomi Hayashi
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuyoshi Sato
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kenji Nakano
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mayu Yunokawa
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Ono
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junichi Tomomatsu
- grid.410807.a0000 0001 0037 4131Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Toshiyasu
- grid.410807.a0000 0001 0037 4131Division of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroki Mitani
- grid.410807.a0000 0001 0037 4131Division of Head and Neck Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- grid.410807.a0000 0001 0037 4131Division of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan ,grid.410807.a0000 0001 0037 4131Pathology Project for Molecular Targets, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan ,grid.486756.e0000 0004 0443 165XDivision of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiichi Mori
- grid.410807.a0000 0001 0037 4131Project for Development of Innovative Research, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Division of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
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Saldivar B, Kharod SM, Mendenhall WM. Small Cell Carcinoma of the Head and Neck: Update on the University of Florida Experience. Cancer Invest 2020; 39:808-811. [PMID: 33356635 DOI: 10.1080/07357907.2020.1849255] [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: 10/22/2022]
Abstract
We updated the University of Florida experience treating head and neck small cell carcinoma. Eight patients received a median of 67.7 Gy between 1989 and 2017. The 2-year rates of local, regional, distant, and disease control were 73, 60, 33, and 13%, respectively. The 2-year overall survival rate was 38%; median survival was 1.4 years. The longest disease-free period was 9.5 years after treatment with no evidence of disease. Radiotherapy is an acceptable treatment for these patients, who tend to have poor outcomes and distant metastatic disease. Superior systemic chemotherapy may improve outcomes and decrease the likelihood of distant recurrence.
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Affiliation(s)
- Brittany Saldivar
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Shivam M Kharod
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA
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34
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Noël A, Rodriguez A, Lelong C, Noël JC. Bilateral synchronous tonsillar metastasis from a mixed form of neuroendocrine tumor in the lung: Case report and literature review. Thorac Cancer 2020; 11:3622-3624. [PMID: 33103339 PMCID: PMC7705623 DOI: 10.1111/1759-7714.13714] [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: 09/26/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/02/2022] Open
Abstract
Here, we report the case of a 54‐year‐old man with a history of squamous cell carcinoma (SCC) of the lung, who developed bilateral neuroendocrine carcinoma (NEC) of the palatine tonsils. Faced with this atypical situation, another biopsy of the lung lesion was performed, revealing NEC histology patterns. This article describes the first case of metastasis to the bilateral palatine tonsils from the NEC component of a mixed NEC/SCC of the lung, highlighting the importance of reconsidering the diagnosis of the primary tumor histology, particularly in lung cancer with the possible presence of mixed tumor after phenotype transdifferentiation of the primary tumor. Key points Significant findings of the study Mixed lung carcinoma can be revealed after the presence of neuroendocrine carcinoma metastasis. What this study adds Bilateral neuroendocrine carcinoma of the palatine tonsils should be considered as metastases, particularly in the presence of lung cancer with a poor response to treatment.
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Affiliation(s)
- Antoine Noël
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, C.H.U Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandra Rodriguez
- Department of Otorhinolaryngology - Head and Neck Surgery, C.H.U Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Clément Lelong
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Christophe Noël
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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35
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Zhou Y, Zhou HC, Peng H, Zhang ZH. Primary small cell neuroendocrine carcinoma of the right posterior tongue. World J Meta-Anal 2020; 8:285-291. [DOI: 10.13105/wjma.v8.i4.285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/30/2020] [Accepted: 08/21/2020] [Indexed: 02/06/2023] Open
Abstract
Small cell neuroendocrine carcinoma (SNEC) is an extremely aggressive tumor and mainly occurs in the lung. Primary extra-pulmonary SNEC is rare. To date, only 11 primary SNECs occurring in the oral cavity have been reported in the English literature. We describe a case of primary SNEC of the right posterior tongue in a 46-year-old man. The patient had stage IVA disease and received adjuvant chemotherapy, followed by radical surgery and radiotherapy. He remained tumor-free for 20 mo before death due to gastrointestinal metastasis. The relevant literature on the 11 previously reported patients was reviewed, and the clinical features, histopathological characteristics, differential diagnosis and therapeutic strategies of this rare tumor were analyzed.
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Affiliation(s)
- Yu Zhou
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Hang-Cheng Zhou
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Hui Peng
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Zhi-Hong Zhang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
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36
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Wang J, Liu D, Meng Y, Guo Y, Zhao M. Extrapulmonary small cell carcinoma of the external auditory canal: a case report and review of the literature. J Int Med Res 2020; 48:300060520946517. [PMID: 32851892 PMCID: PMC7457657 DOI: 10.1177/0300060520946517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/09/2020] [Indexed: 12/02/2022] Open
Abstract
Extrapulmonary small cell carcinoma (EPSCC) affecting the external auditory canal (EAC) is uncommon. We herein report a case involving a 56-year-old man with EPSCC of the EAC who had a 48-year history of recurrent purulent discharge in both ears and a 20-day history of right ear pain and hemorrhage followed by incomplete right eyelid closure and an askew mouth. He underwent surgical removal of middle ear granulation tissue, residual ossicles, and a right EAC mass. Postoperatively, pathomorphological examination combined with immunohistochemical staining supported a diagnosis of small cell carcinoma. Radiation therapy at a dose of 60.06 Gy in 33 daily fractions was completed 1 month after surgery, and synchronous etoposide-cisplatin regimen chemotherapy was performed for two cycles and four sequential cycles. One year postoperatively, magnetic resonance imaging showed no tumor in the ear; however, computed tomography showed multiple liver space-occupying lesions that were considered to indicate liver metastasis. Further chemotherapy was performed, but the patient died 15 months postoperatively. This case indicates that timely and accurate chemoradiotherapy is likely the most reasonable approach to EPSCC of the EAC given the aggressiveness of this tumor.
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Affiliation(s)
- Jianyan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second
Hospital of Jilin University, Changchun, Jilin Province, China
- Department of Otorhinolaryngology Head and Neck Surgery, The Third
Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Danqing Liu
- Department of Otorhinolaryngology Head and Neck Surgery, The First
Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yingdi Meng
- Department of Otorhinolaryngology Head and Neck Surgery, The Second
Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yingyuan Guo
- Department of Otorhinolaryngology Head and Neck Surgery, The Second
Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ming Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Second
Hospital of Jilin University, Changchun, Jilin Province, China
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37
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尹 建, 王 鑫, 傅 仲, 刘 亚, 陈 玮, 朱 雷. [Small cell neuroendocrine carcinoma of larynx: a case report]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:655-657. [PMID: 32791646 PMCID: PMC10133109 DOI: 10.13201/j.issn.2096-7993.2020.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Indexed: 11/12/2022]
Abstract
Small cell neuroendocrine carcinoma(SCNC) of larynx is very rare. Primary small cell neuroendocrine carcinomas constitute less than 0.5% of all laryngeal cancers. Tumor can occur in any laryngeal subsite, while the supraglottis is the most common. Patients usually complaint with hoarseness and neck mass. The diagnosis of this kind of carcinomas relies strictly on histopathological examination and immunohistochemical testing. The prognosis of laryngeal SCNC is generally poor. Here, we report a case of a 55-year-old-male patient who presented with a poorly differentiated SCNC of the supraglottic larynx and neck mass.
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Affiliation(s)
- 建枚 尹
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130000)
| | - 鑫启 王
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130000)
| | - 仲鹰 傅
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130000)
| | | | - 玮伦 陈
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130000)
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38
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Orozco FR, Choi JS, Correa AJ, Voelker CCJ. Temporal Bone Histopathology Case of the Month: Small Cell Neuroendocrine Carcinoma of the External Auditory Canal and Middle Ear. Otol Neurotol 2020; 41:e1279-e1281. [PMID: 33170813 DOI: 10.1097/mao.0000000000002920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Francis Reyes Orozco
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Janet S Choi
- Caruso Department of Otolaryngology-Head and Neck Surgery.,Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Adrian J Correa
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Courtney C J Voelker
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
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39
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Extrapulmonary small cell carcinoma: Prognostic factors, patterns of care, and overall survival. Eur J Surg Oncol 2020; 46:1596-1604. [PMID: 32336623 DOI: 10.1016/j.ejso.2020.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Extrapulmonary small cell carcinoma is a rare malignancy with scarce data. Treatment paradigms extrapolate from pulmonary small cell carcinoma and single institution studies. We analyzed the epidemiology, patterns of care, prognostic factors, and overall survival (OS) of EPSCC patients. METHODS The cohort included EPSCC. Patients with <2 months follow-up, unknown demographic/treatment variables were excluded. Descriptive statistics were performed to characterize the cohort. Kaplan-Meier methods were used to estimate OS. Cox proportional hazard modeling was done to analyze the influence of prognostic variables on OS. RESULTS 5747 patients were included. Median OS was 1.2 years. Head and neck (HR: 0.60, 95% CI 0.53-0.67, p < 0.0001) and breast (HR: 0.69, 95% CI 0.53-0.89, p = .0046) were associated with improved OS; gastrointestinal (HR: 1.19, 95% CI 1.09-1.29, p < .0001) worse OS; and gynecologic (HR: 1.04, 95% CI 0.92-1.17, p = .5660) showing no difference, all compared to genitourinary (reference). Surgery was associated with improved overall survival (HR: 0.84, 95% CI 0.79-0.91, p=<.0001). Chemoradiation showed a decreased HR (HR: 0.91, 95% CI 0.83-0.99, p = .0363) when compared to chemotherapy alone (reference). CONCLUSION EPSCC occurs throughout the body with poor survival. Anatomic subsite was predictive for survival. Surgical resection may improve survival. Concurrent chemoradiation appears to improve survival over chemotherapy alone.
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40
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Bai J, Zhao F, Pan S. Clinicopathological Characteristics and Survival of Small Cell Carcinoma of the Salivary Gland: a Population-Based Study. Cancer Manag Res 2019; 11:10749-10757. [PMID: 31920384 PMCID: PMC6935273 DOI: 10.2147/cmar.s231446] [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: 09/17/2019] [Accepted: 11/08/2019] [Indexed: 12/04/2022] Open
Abstract
Background Small cell carcinoma (SmCC) of the salivary gland is rare, and the characteristics and survival are not well defined due to only case reports or case series being reported. The present study aimed to describe the clinicopathological characteristics and determine the factors associated with survival of this rare cancer. Materials and methods A population-based study was carried out to investigate clinical characteristics and prognosis of SmCC of the salivary gland using prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database between 1988 and 2016. Results Totally, 198 patients with SmCC of the salivary gland were identified with an average age of 72.6±12.4 and a male to female ratio of 3.4:1. The lesions of most patients (167/198) were located in the parotid gland. The median overall survival (mOS) of all patients is 25.0 months. The 1-, 3-, 5- and 10-year survival rate was 65.7%, 40.9%, 33.0% and 22.7%, respectively. Surgery could prolong significantly the mOS by almost 17.0 months (28.0 months vs 11.0 months; P<0.01). Radiotherapy, as well as radiotherapy after surgery, could prolong the mOS (P<0.01 for both). Patients who received chemotherapy had significantly longer overall survival time than those without chemotherapy (28.0 months vs 20 months; P=0.04). The survival analysis demonstrated that old age (>72 years), lymph node (N3) and distant metastases were independent factors for poor survival, whereas radiotherapy was an independent factor for favorable survival. Conclusion Small cell carcinoma of the salivary gland is a rare disease, and old age, lymph node and distant metastases, and radiotherapy were significantly associated with prognosis. In order to understand this disease more thoroughly, more cases with adequate information are required.
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Affiliation(s)
- Jinbo Bai
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People Republic of China
| | - Fen Zhao
- Department of Stomatology, Qilu Children's Hospital of Shandong University, Jinan, Shandong 250022, People Republic of China
| | - Shuang Pan
- Department of Orthodontics, Jinan Stomatological Hospital, Jinan, Shandong 250001, People Republic of China
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41
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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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42
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Benzerdjeb N, Traverse-Glehen A, Philouze P, Bishop J, Devouassoux-Shisheboran M. Poorly differentiated neuroendocrine carcinoma of the head and neck: human papillomavirus tumour status/p16 status and impact on overall survival. Histopathology 2019; 76:581-591. [PMID: 31463946 DOI: 10.1111/his.13982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/06/2019] [Accepted: 08/22/2019] [Indexed: 01/06/2023]
Abstract
AIMS Poorly differentiated neuroendocrine carcinoma (PDNEC) of the head and neck is a rare high-grade neuroendocrine neoplasm. Human papillomavirus (HPV) status and p16 status are as yet unclear among PDNECs, owing to a lack of statistical analysis. The objective of the present study was therefore to evaluate their potential clinicopathological associations, and their prognostic impact on overall survival in PDNECs of the head and neck, regardless to HPV genotype. METHODS AND RESULTS All cases of PDNEC of the head and neck between 1998 and 2019 were identified from the database of the Lyon university hospital pathology department (n = 21); for these cases, p16 immunohistochemistry and HPV in-situ hybridisation were performed. Published cases of PDNEC of the head and neck with assessment of HPV status and p16 status were identified in PubMed (n = 57). Local and published cases were pooled for analysis. HPV positive (HPV+) tumour status was found to be significantly associated with oropharyngeal localisation (P < 0.001) and overexpression of p16 (P < 0.001). Multivariate analysis, adjusted on tumour site, histological subtype, p16 status, HPV status, and source of the case, showed that oropharyngeal localisation [hazard ratio (HR) 3.031, 95% confidence interval (CI) 1.257-7.310] and being a small-cell variant (HR 2.859, 95% CI 1.150-7.109) were significant predictors of worse overall survival; HPV+ tumour status was associated with better overall survival (HR 0.388, 95% CI 0.146-0.995). CONCLUSIONS HPV+ tumour status was associated with oropharyngeal PDNECs and with a better prognosis.
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Affiliation(s)
- Nazim Benzerdjeb
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, France
| | - Alexandra Traverse-Glehen
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, France
| | - Pierre Philouze
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mojgan Devouassoux-Shisheboran
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, France
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43
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Sipos B. [Neuroendocrine neoplasms of the auditory, olfactory, and visual sensory organs]. DER PATHOLOGE 2019; 39:255-263. [PMID: 29392404 DOI: 10.1007/s00292-017-0411-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Neuroendocrine neoplasms (NENs) are infrequent in sensory organs. There are well-differentiated neuroendocrine neoplasms that should be classified as neuroendocrine tumors, in analogy to their gastrointestinal counterparts, however the nomenclature is inconsistent. The best defined entities are neuroendocrine tumors in the middle ear and ectopic pituitary adenoma in the sphenoid region. Poorly differentiated NENs most often arise in the olfactory organ and nasal cavity that are represented by olfactory neuroblastomas and poorly differentiated neuroendocrine carcinomas. They have several mimickers such as the sinonasal undifferentiated carcinoma, poorly differentiated squamous cell carcinoma, mucosal malignant melanoma, rhabdomyosarcoma, Ewing sarcoma/primitive neuroectodermal tumor and non-Hodgkin lymphoma.
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Affiliation(s)
- B Sipos
- Institut für Allgemeine Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland.
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44
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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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45
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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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46
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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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Ao YJ, Zhou SH. Primary poorly differentiated small cell type neuroendocrine carcinoma of the hypopharynx. Onco Targets Ther 2019; 12:1593-1601. [PMID: 30881014 PMCID: PMC6398402 DOI: 10.2147/ott.s189241] [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: 11/23/2022] Open
Abstract
The incidence of primary poorly differentiated neuroendocrine carcinoma (PDNC) of the hypopharynx iŝ4%. However, the disease pathogenesis, natural history, and prognostic factors remain poorly understood. We report the case of a 66-year-old man who presented with multiple metastases from primary PDNC of the hypopharynx. Physical examination revealed ã3×4 cm left cervical mass located at the level III, with tenderness and an unclear boundary. Laryngoscopy revealed a large mass arising from the posterior hypopharynx; glottis and vocal cord movements were invisible. After consultation with our head and neck oncological multidisciplinary team, diagnosis and specific treatment plan were made. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed small cell carcinoma. Immunohistochemical staining identified neoplastic cells that were positive for cytokeratins, CD56, chromogranin A, and synaptophysin. The Ki-67 mitotic index approached 80%. These findings confirmed hypopharyngeal PDNC, and chemotherapy was prescribed. After 7 months, the tumor metastasized to the left side of the anterior chest wall, bilateral lungs, left liver, and skeleton. The soft tissue of the chest wall was biopsied, and pathology revealed PDNC. Subsequent examinations over the next 4 months confirmed multiple liver metastatic lesions. The patient succumbed to the cancer progression a month later. Here, we systematically review the clinical manifestations, pathogenesis, prognostic factors, and treatment of the disease. In conclusion, patients always have a poor prognosis due to a lack of optimal treatment.
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Affiliation(s)
- Yin-Jie Ao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province 310003, China,
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province 310003, China,
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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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49
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Ahmad I, Singh P, Bhatt CP, Bashir I. Case of metastatic small cell carcinoma of the oropharynx successfully treated with image-guided volumetric modulated arc therapy (IG-VMAT): pushing the limits of technology to match treatment intent. BMJ Case Rep 2018; 11:11/1/bcr-2018-226522. [PMID: 30567165 DOI: 10.1136/bcr-2018-226522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Extrapulmonary small cell carcinomas (EPSCC) are a rare subtype of neuroendocrine tumours which have been documented to arise from a multitude of sites and treatment outcomes are disappointing. The most common site involved in the head and neck region is the larynx and the oropharynx as a primary site has been infrequently reported. The patient presented with bilateral neck swelling and an ulcerated lesion was noted in the base of tongue (BOT). A biopsy revealed small cell carcinoma (SCC) and was confirmed with immunohistochemistry. The final diagnosis after workup was SCC of BOT stage IVc. He received induction chemotherapy to which the tumour responded partially, followed by curative intent chemoradiotherapy and adjuvant chemotherapy. The patient achieved a radiological complete response to treatment and almost all treatment-induced toxicities resolved. An aggressive approach to managing EPSCC is possible with modern radiotherapy techniques, with tolerable treatment-induced toxicities.
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Affiliation(s)
- Irfan Ahmad
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Pavel Singh
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
| | - Chandi Prasad Bhatt
- Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
| | - Irfan Bashir
- Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
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50
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Smith J, Kulkarni A, Birkeland AC, McHugh JB, Brenner JC. Whole-Exome Sequencing of Sinonasal Small Cell Carcinoma Arising within a Papillary Schneiderian Carcinoma In Situ. Otolaryngol Head Neck Surg 2018; 159:859-865. [PMID: 29734873 PMCID: PMC6212311 DOI: 10.1177/0194599818774004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/10/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The pathogenetic underpinnings of extrapulmonary small cell carcinomas (EPSCCs) of the head and neck are poorly understood. We sought to describe the clinical case and whole-exome DNA sequencing data of a patient with sinonasal Schneiderian carcinoma in situ whose tumor progressed to small cell carcinoma (SCC). STUDY DESIGN Case report and whole-exome sequencing of tumor DNA. SETTING Academic medical center. SUBJECTS AND METHODS A 52-year-old man with sinonasal Schneiderian carcinoma in situ whose tumor progressed to small cell carcinoma. We performed whole-exome genetic sequencing and copy-number variation (CNV) analysis of tumor and normal DNA extracted from flash-frozen, paraffin-embedded (FFPE) samples. RESULTS A total of 93 high-confidence, nonsynonymous somatic mutation events were identified in sinonasal SCC, including loss-of-function mutations in TP53, MAML3, a transcriptional coactivator of the Notch pathway, and GAS6, an activating ligand of the TAM family of tyrosine kinase receptors. Focal amplifications of chromosomal regions 6p25-11.1, containing SOX4 and VEGFA, and 14q32.1-32.3, containing AKT1 and the Notch inhibitory ligand DLK1, were also seen. Further CNV analysis revealed deletions in the critical cell cycle regulators CDKN2A, RB1, RBL1, and RBL2 and the chromatin modifier EP300. CONCLUSIONS Small cell carcinoma may rarely arise from sinonasal Schneiderian carcinoma in situ and exhibits similar genomic aberrations (eg, SOX amplification, Notch pathway inactivation) to pulmonary small cell carcinoma.
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Affiliation(s)
- Joshua Smith
- Department of Otolaryngology – Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
| | - Aditi Kulkarni
- Department of Otolaryngology – Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
| | - Andrew C Birkeland
- Department of Otolaryngology – Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
| | - Jonathan B. McHugh
- Department of Otolaryngology – Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
| | - J. Chad Brenner
- Department of Otolaryngology – Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
- Program in Cellular and Molecular Biology, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI. University of Michigan Medical School, Ann Arbor, MI
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