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D'Mello K, Cevik J, Wong DJY, Hart C. Therapeutic challenges in small cell carcinoma of the larynx. BMJ Case Rep 2024; 17:e258269. [PMID: 38262714 PMCID: PMC10826497 DOI: 10.1136/bcr-2023-258269] [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: 01/25/2024] Open
Abstract
Primary small cell neuroendocrine carcinoma (SCNC) of the larynx is a rare subtype of laryngeal cancer, accounting for less than 1% of all laryngeal tumours. It most commonly affects smokers in their fifth to sixth decade of life and is characterised by a high incidence of advanced disease at presentation and an aggressive clinical course. Here we present a case of SCNC of the larynx, presenting initially with dysphonia, and an associated literature review collating current knowledge regarding therapeutic approaches. After review of 260 cases in the literature we determined a disease-specific survival of 33.1%. Combined chemoradiotherapy is currently the recommended first-line treatment option.
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Affiliation(s)
- Kimberly D'Mello
- Otolaryngology, Head & Neck Surgery, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - Jevan Cevik
- Otolaryngology, Head & Neck Surgery, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - Daniel Jun Yi Wong
- Otolaryngology, Head & Neck Surgery, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - Cameron Hart
- Otolaryngology, Head & Neck Surgery, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
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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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Gu Y, Liu D, Gao X, Zhou H, Song P, Qian X. Primary Surgical Management of Laryngeal Neuroendocrine Neoplasms: A Single Institution Case Series. EAR, NOSE & THROAT JOURNAL 2023:1455613231183882. [PMID: 37522341 DOI: 10.1177/01455613231183882] [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: 08/01/2023] Open
Abstract
Objective: Laryngeal neuroendocrine neoplasms (NENs) are rare diseases. A single institution retrospective study was done of the outcome of patients with laryngeal NENs who undergo primary surgery as the first treatment modality. Methods: Retrospective analysis of medical records of patients with laryngeal NENs between 2009 and 2018. Cases were classified by applying the 2022 World Health organization Classification of Head and Neck Tumors (5th edition). Results: Six patients were eligible at our tertiary center: 1 large cell neuroendocrine carcinoma (NEC), 3 small cell NEC, 1 neuroendocrine tumor grade 1, and 1 neuroendocrine tumor grade 2. All admitted patients received upfront surgeries, including 3 transoral CO2 laser surgeries and 3 total laryngectomies with or without elective neck dissection. Four patients underwent subsequent chemoradiotherapy. Although 3 patients had recurrent disease and distal metastasis, the overall survival was generally improved. Conclusion: According to our institutional experience, upfront surgery in the first-line setting of a multi-modality approach with adjuvant chemoradiotherapy plays a very important role in managing laryngeal NECs, and may confer additional survival benefit in some patients of the large cell carcinoma subgroup.
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Affiliation(s)
- Yajun Gu
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
| | - Dingding Liu
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
| | - Xinyu Gao
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
| | - Han Zhou
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
| | - Panpan Song
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
| | - Xiaoyun Qian
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
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Tang H, Wang L, Xu W, Xu Y, Li X, Guo D. Secondary Sinonasal Collision Tumor of Papillary Squamous Cell Carcinoma and Small Cell Neuroendocrine Carcinoma After Nasopharyngeal Carcinoma Radiotherapy: A Case Report and Literature Review of Sinonasal Collision Carcinomas. Onco Targets Ther 2023; 16:91-97. [PMID: 36817507 PMCID: PMC9930577 DOI: 10.2147/ott.s396703] [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: 11/09/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
In the head and neck region, small cell neuroendocrine carcinoma (SmNEC) is extraordinary infrequent. Collision malignancy is also a rare entity in the nasal cavity, with merely sporadic 6 case reports on primary collision tumor associated with neuroendocrine carcinoma. The development of a secondary SmNEC within the previous radiation field had uncommonly been described, and there was no report on secondary sinonasal collision carcinoma with SmNEC component as a side reaction of nasopharyngeal carcinoma (NPC) radiotherapy. In light of the rarity of these neoplasms, we presented a case of a sinonasal collision carcinoma of papillary squamous cell carcinoma (PSCC) and SmNEC after NPC radiotherapy. To our knowledge, it may be the first case of a secondary coexistence of two malignancies synchronously in the nasal cavity after NPC treatment. Recognizing this peculiar kind of collision tumor associated SmNEC could promote our understanding of this entity and hence propose optimal treatment strategies.
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Affiliation(s)
- Hao Tang
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Lina Wang
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Wenfeng Xu
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Yujuan Xu
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Xianyun Li
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Deyu Guo
- Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China,Correspondence: Deyu Guo, Department of Pathology, Guiqian International General Hospital, Guiyang, Guizhou, People’s Republic of China, Email
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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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Mesolella M, Allosso S, Buono S, Ricciardiello F, Motta G. Neuroendocrine carcinoma of the larynx with Lambert-Eaton myasthenic syndrome: a rare case report and literature review. J Int Med Res 2021; 49:3000605211014784. [PMID: 33983073 PMCID: PMC8127768 DOI: 10.1177/03000605211014784] [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: 01/03/2023] Open
Abstract
This current report describes a rare clinical case of neuroendocrine carcinoma (NEC) of the larynx with associated Lambert-Eaton myasthenic paraneoplastic syndrome (LEMS). A 68-year-old male patient presented with severe dysphonia and dysphagia. He underwent a total laryngectomy and the excised lesion was extremely large. A pathological examination demonstrated ‘morphological findings of a poorly differentiated carcinoma (G3) with aspects of neuroendocrine differentiation’ (i.e. a poorly differentiated neuroendocrine carcinomas [PD-NEC]). Based on the patient’s medical history and the immunohistochemical findings, he was treated with three cycles of neoadjuvant chemotherapy (cisplatin–etoposide) and then radiotherapy with a total dose of 70 Gy. Of the 10 cases of paraneoplastic syndrome (PNS) related to laryngeal NEC reported in the literature, nine of these syndromes were of an endocrine type. Only one case of PNS associated with laryngeal cancer had a neurological manifestation, which was LEMS. To the best of our knowledge, this current case has only one similar precedent in the literature and it is the second report of an association between a PD-NEC and LEMS. Laryngeal NECs are rare lesions with different prognostic characteristics. The diagnosis should be made using an endocrinological, neurological, radiological and histological multidisciplinary approach. A radical surgical approach is recommended.
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Affiliation(s)
- Massimo Mesolella
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | - Salvatore Allosso
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | - Sarah Buono
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | | | - Gaetano Motta
- Unit of Otorhinolaryngology, University Luigi Vanvitelli, Napoli, Italy
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Yan O, Xie W, Teng H, Fu S, Chen Y, Liu F. Nomograms Forecasting Long-Term Overall and Cancer Specific Survival of Patients With Head and Neck Neuroendocrine Carcinoma. Front Oncol 2021; 11:619599. [PMID: 33659217 PMCID: PMC7917297 DOI: 10.3389/fonc.2021.619599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/08/2021] [Indexed: 02/05/2023] Open
Abstract
Background The purpose of this retrospective analysis was to build and validate nomograms to predict the cancer-specific survival (CSS) and overall survival (OS) of head and neck neuroendocrine carcinoma (HNNEC) patients. Methods A total of 493 HNNEC patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015, and 74 HNNEC patients were collected from the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital (HCH) between 2008 and 2020. Patients from SEER were randomly assigned into training (N=345) and internal validation (N=148) groups, and the independent data group (N=74) from HCH was used for external validation. Independent prognostic factors were collected using an input method in a Cox regression model, and they were then included in nomograms to predict 3-, 5-, and 10-year CSS and OS rates of HNNEC patients. Finally, we evaluated the internal and external validity of the nomograms using the consistency index, while assessing their prediction accuracy using calibration curves. A receiver operating curve (ROC) was also used to measure the performance of the survival models. Results The 3-, 5-, and 10-year nomograms of this analysis demonstrated that M classification had the largest influence on CSS and OS of HNNEC, followed by the AJCC stage, N stage, age at diagnosis, sex/gender, radiation therapy, and marital status. The training validation C-indexes for the CSS and OS models were 0.739 and 0.713, respectively. Those for the internal validation group were 0.726 and 0.703, respectively, and for the external validation group were 0.765 and 0.709, respectively. The area under the ROC curve (AUC) of 3-, 5-, and 10-year CSS and OS models were 0.81, 0.82, 0.82, and 0.78, 0.81, and 0.82, respectively. The C-indexes were all higher than 0.7, indicating the high accuracy ability of our model's survival prediction. Conclusions In this study, prognosis nomograms in HNNEC patients were constructed to predict CSS and OS for the first time. Clinicians can identify patients' survival risk better and help patients understand their survival prognosis for the next 3, 5, and 10 years more clearly by using these nomograms.
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Affiliation(s)
- Ouying Yan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Wenji Xie
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Haibo Teng
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shengnan Fu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Yanzhu Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Feng Liu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China.,Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Böhm F, Schuler PJ, Döscher J, Weissinger SE, Benckendorff J, Greve J, Hoffmann TK, Theodoraki MN. [Primary small cell neuroendocrine carcinoma of the larynx: a review of literature and case series]. Laryngorhinootologie 2021; 100:981-986. [PMID: 33395712 DOI: 10.1055/a-1334-4444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Small cell neuroendocrine carcinoma (SCNC) of the larynx is a rare tumor entity with a 5-year overall survival (OS) of only 5 % after treatment with chemoradiotherapy. METHODS A systematic review of the literature was performed for "SCNC" and "SCNC in head and neck". Our hospital's own electronic patient file database was investigated for patients diagnosed with a SCNC over the last 12 years. RESULTS The effectiveness of chemoradiotherapy in SCNC is still unclear since randomized clinical trials are missing for the evaluation of standard of care treatment. Common therapy approaches are based on experiences with small cell lung cancer. 0.5 % of all SCNC occur in the head and neck region. In the last 12 years, we diagnosed 9 patients with SCNC, two of which were located in the larynx. Exemplarily, we report the case of a 29-year-old male with the initial diagnosis of a SCNC of the larynx with concurrent lymph node metastasis. This case is particularly interesting due to the young age at disease onset and the lack of major risk factors. Treatment was modified to nivolumab due to progressive disease after treatment with chemoradiotherapy. After an OS of 22 months, the patient deceased due to a tumor-associated major bleeding with airway obstruction. CONCLUSION So far there are no clinical reports evaluating the use of nivolumab in third-line-therapy of SCNC. NTRK fusion (neurotrophic tyrosine receptor kinase gene fusion) or the folate receptor expression analysis should be considered to evaluate the potential use of a tropomyosin receptor kinase inhibitor or a folate receptor targeting therapy.
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Affiliation(s)
- Felix Böhm
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
| | - Patrick J Schuler
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
| | - Johannes Döscher
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
| | | | | | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
| | - Marie-Nicole Theodoraki
- Department of Otorhinolaryngology, Head and Neck Surgery, University Ulm Medical Centre, Ulm, Germany
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Forsyth AM, Camilon PR, Tracy L, Levi JR. Pediatric laryngeal tumors and demographics, management, and survival in laryngeal squamous cell carcinoma. Int J Pediatr Otorhinolaryngol 2021; 140:110507. [PMID: 33279850 DOI: 10.1016/j.ijporl.2020.110507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/22/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the prevalence and features of pediatric laryngeal malignancies and to review the demographics, management, and survival of pediatric patients with laryngeal squamous cell carcinoma as compared to adult patients. METHODS Patients aged 0 (younger than 1) to 18 with laryngeal malignancy identified in the Surveillance, Epidemiology, and End Results (SEER) database were included from 1973 to 2016 published April 2019. Diagnosis of malignant laryngeal tumor was made using the 3rd edition of the International Classification of Diseases for Oncology (ICDO-3) code: C32.0 Glottis, C32.1 Supraglottis, C32.2Subglottis, andC32.9 Larynx primary site. RESULTS 23 cases of pediatric laryngeal malignancies were identified. 16 cases were squamous cell carcinomas and 7 were other histologic types. Pediatric laryngeal SCC tended to be diagnosed in adolescence (mean age 14.8 years, range younger than 1 to 18, 82.6% of cases were age 12 and above). Management of laryngeal SCC included no recorded treatment (18.8%), primary radiation (18.8%), primary surgery (12.5%), radiation and surgery (25%), radiation and chemotherapy combined (18.8%), and surgery with radiation and chemotherapy (12.5%). Surgeries were local excision, excision and lymphnode dissection, as well as total laryngectomy, and not otherwise specified. The 2-year and 5-year overall and disease-specific survivals were 78.6%. CONCLUSIONS Pediatric laryngeal cancer is rare. Squamous cell carcinoma is the most commonly diagnosed malignant laryngeal histology affecting pediatric patients. Despite different risk factors, survival rates remain similar for pediatric patients with laryngeal squamous cell carcinoma as compared to adults. Physicians should include laryngeal cancer in the differential for pediatric patients with hoarseness, dysphagia, and progressive airway obstruction to avoid a late diagnosis.
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Affiliation(s)
| | - P Ryan Camilon
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, MA, USA; Department of Otolaryngology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lauren Tracy
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, MA, USA
| | - Jessica R Levi
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, MA, USA.
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Chen L, Deng W, Li C, Lau H, Tao L, Wang S, Zhou L, Zhang M. Clinical outcome and comparison between squamous and non-squamous cell carcinoma of the larynx. Acta Otolaryngol 2020; 140:195-201. [PMID: 31852360 DOI: 10.1080/00016489.2019.1700305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The various pathological types of non-squamous cell carcinomas (nSCCs) of the larynx accounted for about 5% laryngeal malignancies, but the knowledge regarding these pathological behaviors, therapeutic models and prognostic factors was limited.Objectives: To investigate the clinical characteristics and the survival outcomes of nSCCs of the larynx.Material and methods: A total of 106 patients diagnosed with laryngeal nSCC between 2003 and 2014 were retrospectively investigated from a cohort of 4,796 patients with laryngeal malignancies.Results: Spindle cell carcinoma, malignant salivary gland carcinoma, neuroendocrine carcinoma, non-Hodgkin's lymphomas, and carcinosarcoma accounted for the majority of the nSCCs of the larynx. In laryngeal nSCCs (excluding non-Hodgkin lymphomas), there was no significant difference in overall survival (OS) by tumor subsite (p = .818), clinical-stage (p = .051) or T stage (p = .412), but the difference in OS by N stage was statistically significant (p = .001). Upon comparison of propensity score-matched groups, the OS was longer in SCCs of the larynx (p = .0004).Conclusions and significance: Primary nSCC of the larynx is rare, and its diagnosis depends on comprehensive immunohistochemical examination, as the clinical characteristics are non-specific compared with SCC. The overall prognosis of nSCC is relatively poor compared with that of SCC in the larynx.
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Affiliation(s)
- Le Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Weiye Deng
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cai Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Huiching Lau
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Lei Tao
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Shuyi Wang
- Department of Pathology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Liang Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Ming Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
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Rare cases of head and neck's neuroendocrine carcinomas disease: Case series of 4 patients and review of the literature. Int J Surg Case Rep 2019; 66:270-276. [PMID: 31884263 PMCID: PMC6939065 DOI: 10.1016/j.ijscr.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/27/2019] [Accepted: 12/04/2019] [Indexed: 12/28/2022] Open
Abstract
Cervical lymph node SmCC as a primary tumor’s location, was never described in the literature according to what we know. AC neuroendocrine carcinoma of the tonsil has never been described in the literature up to our knowledge. A review of the literature was performed, indicating treatment and disease’s prognosis. In 2012, the 2005 WHO classification of neuroendocrine tumors of the head and neck region was modified by adding the ranges of the Ki-67 and suggested that LCNEC should be considered a distinct disease entity and be separated from AC.
Introduction Primary neuroendocrine carcinomas are uncommon head and neck malignancies. Their classification is still debated. We report four cases of unusual primary locations of neuroendocrine carcinomas of head and neck region emphasizing two entities and rare sites that were never described in the literature to the best of our knowledge. Presentation of cases We reported four different cases of neuroendocrine carcinomas (nasal cavity, larynx, lymph nodes and tonsil) treated in our institution. The diagnosis was made by biopsy and confirmed by Immunohistochemical study. We underscored 2 atypical and rare entities in their location and anatomo histopathological type. Chemotherapy and radiotherapy were proposed for patients with nasal’s and laryngeal locations. This latter had also undergone surgery. For lymph node location, the patient received decompressive radiotherapy alone. The patient diagnosed with neuroendocrine carcinoma of the tonsil didn’t get any treatment except initial tonsillectomy for diagnosis purposes. Regarding the evolution in our case series, 2 patients had a relapse with local and regional metastasis. Among the 4 patients, 50 % passed away, one is still alive with deterioration of his general status and one is lost to follow-up and refused undergoing further investigations. Discussion There is confusion in the literature regarding the classification of neuroendocrine carcinomas. According to the 2005 WHO, these lesions, can be subdivided into TC, AC (including LCNEC), SmCC, combined SmCC with nonsmall cell carcinoma, and paraganglioma. Their treatment is still debated. Through an overview of the literature, we have gathered the main studies and 2 meta-analysis summarizing the mainstay treatment and disease’s outcome. Conclusion Neuroendocrine carcinomas of head and neck region are aggressive tumors with poor prognosis, low incidence and their diagnosis is not obvious. The treatment protocol depends on the type, the site of the lesions, and metastasis status. It’s still not well codified.
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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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13
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Iqbal MS, Matthews S, Chambers A, Kelly C, Ahmed O, Adams J. Small cell neuroendocrine carcinoma of the alveolar process of maxilla. Oral Oncol 2018; 86:308-311. [PMID: 30297229 DOI: 10.1016/j.oraloncology.2018.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Alveolar Process/diagnostic imaging
- Alveolar Process/pathology
- Alveolar Process/surgery
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/therapy
- Chemotherapy, Adjuvant
- Fatal Outcome
- Female
- Humans
- Maxilla/diagnostic imaging
- Maxilla/pathology
- Maxilla/surgery
- Maxillary Neoplasms/diagnosis
- Maxillary Neoplasms/pathology
- Maxillary Neoplasms/therapy
- Maxillary Osteotomy
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/therapy
- Radiotherapy, Adjuvant
- Treatment Outcome
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Affiliation(s)
- Muhammad Shahid Iqbal
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
| | - Sarah Matthews
- Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anne Chambers
- Department of Pathology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Charles Kelly
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Omar Ahmed
- Department of Plastic Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James Adams
- Department of Maxillofacial Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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14
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Sun R, Fairchild A, Debenham B. Small Cell Carcinoma of the Hypopharynx. Cureus 2018; 10:e2987. [PMID: 30397561 PMCID: PMC6211776 DOI: 10.7759/cureus.2987] [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: 11/23/2022] Open
Abstract
Small cell carcinoma is rarely found to originate from the hypopharynx and there exists no treatment guidelines due to the small number of cases. Here, we present a case of a female patient with metastatic small cell carcinoma originating from the posterior hypopharynx with lymph node involvement. Her treatment consisted of chemotherapy with etoposide and cisplatin as well as radiation therapy. Her post-treatment computed tomography (CT) scan indicated resolution of the disease at the primary site and follow-up positron emission tomography (PET)-CT scan at three-month post radiation therapy revealed that the patient is clear of the disease.
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Affiliation(s)
- Ruixiang Sun
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, CAN
| | - Alysa Fairchild
- Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, CAN
| | - Brock Debenham
- Radiation Oncology, Cross Cancer Center, University of Alberta, Edmonton, CAN
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15
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Raposo A, Marco A, García-Solano ME, Martínez-Ortiz MJ, García-Purriños F, Lajara J. Primary small cell carcinoma of the larynx. Survival time of 47 months. Case report. Ann Med Surg (Lond) 2018; 30:46-49. [PMID: 29946458 PMCID: PMC6016440 DOI: 10.1016/j.amsu.2018.04.031] [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] [Received: 02/01/2018] [Revised: 03/21/2018] [Accepted: 04/23/2018] [Indexed: 12/04/2022] Open
Abstract
Small cell carcinoma (SCC) of the larynx is a rare type of neuroendocrine carcinoma (NEC), few cases of which have been described in the literature. The prognosis for this type of carcinoma is poor, with a survival time typically not exceeding two years. We describe the case of a 54-year-old male patient with a primary tumor in the right ventricular band and a biopsy compatible with SCC. The patient underwent radiotherapy (RT) and concomitant chemotherapy (QT) and, after a relapse at 17 months, underwent total laryngectomy with bilateral neck dissection. The survival time was 47 months. Further studies are required to elucidate the possible causes of the better prognosis in some cases. The incidence of SCC of the larynx has increased in recent decades, although it still remains rare. The survival rates are 16% for two years and 5% for five years. We describe the case of a 54-year-old male who is still alive, a survival time of more than 44 months.
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Affiliation(s)
- A Raposo
- Hospital Universitario Los Arcos del Mar Menor (HULAMM), Torre Octavio Street, San Javier, 30739, Murcia, Spain
| | | | | | | | | | - J Lajara
- Medicine School at Catholic University, San Antonio, Murcia, Spain
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16
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How phenotype guides management of the neuroendocrine carcinomas of the larynx. The Journal of Laryngology & Otology 2018; 132:568-574. [DOI: 10.1017/s0022215118000968] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractObjectiveThis review aimed to critically analyse data pertaining to the clinical presentation and treatment of neuroendocrine carcinomas of the larynx.MethodA PubMed search was performed using the term ‘neuroendocrine carcinoma’. English-language articles on neuroendocrine carcinoma of the larynx were reviewed in detail.Results and conclusionWhile many historical classifications have been proposed, in contemporary practice these tumours are sub-classified into four subtypes: carcinoid, atypical carcinoid, small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma. These tumours exhibit a wide range of biological behaviour, ranging from the extremely aggressive nature of small and large cell neuroendocrine carcinomas, which usually have a fatal prognosis, to the less aggressive course of carcinoid tumours. In small and large cell neuroendocrine carcinomas, a combination of irradiation and chemotherapy is indicated, while carcinoid and atypical carcinoid tumour management entails conservation surgery.
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17
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Ho WJ, Rooper L, Sagorsky S, Kang H. A robust response to combination immune checkpoint inhibitor therapy in HPV-related small cell cancer: a case report. J Immunother Cancer 2018; 6:33. [PMID: 29743117 PMCID: PMC5943998 DOI: 10.1186/s40425-018-0348-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/29/2018] [Indexed: 02/01/2023] Open
Abstract
Background Human papillomavirus-related small cell carcinoma of the head and neck is an extremely rare, aggressive subtype with poor outcomes. Therapeutic options are limited and are largely adopted from small cell lung cancer treatment paradigms. Case presentation This report describes a 69-year old male who was diagnosed of HPV-related oropharyngeal cancer with mixed small cell and squamous cell pathology which was clinically aggressive and progressed through multimodal platinum-based therapies. Upon manifestation of worsening metastatic disease, the patient was initiated on a combination of ipilimumab and nivolumab. Within 2 months of starting immunotherapy, a robust partial response was observed. During the treatment course, the patient developed immune-related adverse effects including new diabetes mellitus, colitis, and hypothyroidism. The disease-specific survival was 26 months. Conclusion Combination immunotherapy may be an attractive option for HPV-related small cell head and neck cancers resistant to other treatment modalities and thus warrants further evaluation. Electronic supplementary material The online version of this article (10.1186/s40425-018-0348-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Won Jin Ho
- Department of Oncology, Johns Hopkins University School of Medicine, 1650 Orleans St, CRB1 Rm#186, Baltimore, MD, 21287, USA
| | - Lisa Rooper
- Department of Pathology, Johns Hopkins University School of Medicine, 410 N Broadway, Rm#2249, Baltimore, MD, 21287, USA
| | - Sarah Sagorsky
- Department of Oncology, Johns Hopkins University School of Medicine, 1650 Orleans St, CRB1 G86, Baltimore, MD, 21287, USA
| | - Hyunseok Kang
- Department of Oncology, Johns Hopkins University School of Medicine, 1550 Orleans St, CRB2 5m44, Baltimore, MD, 21287, USA.
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18
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du Plessis M, Hage R. Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010. Cancer Causes Control 2017; 28:1227-1239. [PMID: 28762075 DOI: 10.1007/s10552-017-0934-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 07/25/2017] [Indexed: 12/28/2022]
Abstract
Very little data exist on the incidence and burden of cancer in the individual Caribbean countries. Some data are available for larger areas, reported under a bigger geographical region; Latin America and the Caribbean, but many of the individual countries are not included. One of the main reasons is a lack of official cancer registries. Data are usually collected from hospital records or private physician records, and since it is not in an official registry, these data are not always accessible for inclusion in databases such as SEER and GLOBOCAN. Grenada is one of the countries that currently does not have a registry. Our aim is to report on the incidence for head and neck cancer with subcategories; hypopharynx, oropharynx, oral cavity, salivary glands, and larynx from data collected by the sole ear nose and throat specialist over a 20-year period. The age adjusted incidence per 100,000 for these cancers, whether combined or individually, is lower than that of similar populations. The incidence in males is only slightly higher than those reported in some parts of Africa. In females, only Eastern Africa is reported to have a lower incidence than that found in our study. While the incidence of oral cancers is lower than that of African Americans, the survival rate is comparable. Socioeconomic status, lack of infrastructure, and advanced stage at diagnosis appear to be closely related to the survival rate. Incidence reports suggest that incidence of head and neck cancers in individuals of African descent is lower than other populations. It is therefore not surprising that the incidence in Grenada is relatively low, although the incidence may be underestimated.
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Affiliation(s)
- Maira du Plessis
- Department of Anatomical Sciences, St Georges University, West Indies, Grenada.
| | - Robert Hage
- Department of Anatomical Sciences, St Georges University, West Indies, Grenada
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Arango JF, López JC, Arrazubi V, Cisneros S, Rodríguez A, Zabala A, Martinez Del Prado P. An unusual neck tumor in a young pregnant woman: challenge diagnosis and response to treatment. Oxf Med Case Reports 2017; 2017:omx039. [PMID: 28852532 PMCID: PMC5569942 DOI: 10.1093/omcr/omx039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 05/09/2017] [Accepted: 06/09/2017] [Indexed: 11/13/2022] Open
Abstract
We report the case of a 19-year-old woman 33 weeks pregnant who presented a painful mass of progressive growth in the neck, having also dysphonia and dyspnea. Physical examination revealed a primary laryngeal tumor. A neuroendocrine small-cell carcinoma was diagnosed after histopathology, immunohistochemistry and genetic studies. Chemo-radiotherapy with a cisplatin-etoposide schedule was administered. Despite obtaining a complete response, the patient relapsed and finally survived 35 months with successive cisplatin-based treatments. Small-cell neuroendocrine carcinoma of the larynx is an uncommon entity, differential diagnosis can be problematic and treatment is challenging.
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Affiliation(s)
- Juan F Arango
- Department of Medical Oncology, Hospital Universitario Basurto, Bilbao, Spain
| | - Juan C López
- Department of Pathology, Hospital Universitario Basurto, Bilbao, Spain
| | - Virginia Arrazubi
- Department of Medical Oncology, Hospital Universitario Basurto, Bilbao, Spain
| | - Silvia Cisneros
- Department of Radiology, Hospital Universitario Basurto, Bilbao, Spain
| | - Angel Rodríguez
- Department of Radiation Oncology, Hospital Universitario Basurto, Bilbao, Spain
| | - Aitor Zabala
- Department of Otolaryngology, Hospital Universitario Basurto, Bilbao, Spain
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