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Diao W, Liang Y, Gao L, Zhu Y, Zhu X, Yu S, Xia X, Chen X. Clinical characteristics of paraneoplastic syndromes in patients with head and neck cancer. Laryngoscope Investig Otolaryngol 2022; 7:1002-1010. [PMID: 36000027 PMCID: PMC9392377 DOI: 10.1002/lio2.849] [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: 03/27/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/09/2022] Open
Abstract
Background To summarize the clinical manifestations, diagnosis, and prognosis of head and neck cancer (HNC) patients with paraneoplastic syndromes (PNS). Methods The clinical data of 1958 patients with HNC admitted to our hospital from January 1996 to December 2020 were retrospectively analyzed. Demographic and cancer-related characteristics were extracted. Kaplan-Meier survival curves were compared by log-rank test. Cox regression was performed to evaluate prognostic factors and hazard ratio. Results Totally 40 HNC patients with PNS were included in the final analysis, including 36 men and four women with a mean age of 60.4 years (range 40-82). PNS was dermatologic or cutaneous in 23 (57.50%) patients, endocrine in 10 (25.00%), neurologic in five (12.50%), and osteoarticular or rheumatologic in two (5.00%). Twenty-five (62.50%) patients had Stage III/IV cancer. PNS regressed after antitumor therapy in 28 (70.00%) patients. Recurrence of PNS was observed in nine of 12 (75.00%) patients with cancer recurrence or metastasis. The 5-year overall survival (OS) and disease-free survival (DFS) rates of patients with PNS were 51.52% and 44.44%, respectively. The DFS (p = .001) and OS (p = .003) of patients presented with PNS prior to HNC diagnosis were significantly longer than those of patients with synchronous or metachronous PNS. PNS diagnosed before HNC (adjusted hazard ratio [aHR]: 0.31, 95% confidence interval [CI]: 0.11-0.85, p = .02), Stage IV disease (aHR: 3.27, 95% CI: 1.18-9.05, p = .02), and smoking history (aHR: 3.69, 95% CI: 1.04-13.05, p = .04) were significantly associated with OS and DFS. Conclusions Early recognition of PNS could provide clues about underlying tumor condition and result in early diagnosis. Prompt detection of cancer-associated syndromes could lead to a more favorable prognosis for these patients.
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Affiliation(s)
- Wenwen Diao
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Ya Liang
- Department of OtorhinolaryngologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Liming Gao
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Yingying Zhu
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Xiaoli Zhu
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Shuting Yu
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Xin Xia
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Xingming Chen
- Department of Otolaryngology–Head and Neck SurgeryPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
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Rinaldo A, Coca-Pelaz A, Silver CE, Ferlito A. Paraneoplastic Syndromes Associated with Laryngeal Cancer. Adv Ther 2020; 37:140-154. [PMID: 31802393 PMCID: PMC6979447 DOI: 10.1007/s12325-019-01160-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Paraneoplastic syndromes occur rarely in association with laryngeal cancer. When present, the syndrome may be the first sign of the malignancy. The aim of the present study was to review and report on all published cases in the international literature. METHODS A search of PubMed was conducted for "paraneoplastic syndromes in laryngeal cancer" without any restrictions on language or publication year. The full texts of all relevant articles were reviewed and all cases of paraneoplastic syndromes associated with any type of laryngeal cancer were extracted and analyzed. RESULTS We identified 59 cases of paraneoplastic syndromes related to laryngeal cancer in the literature published from 1963 until recently. There were 46 squamous cell carcinomas and 10 neuroendocrine carcinomas. Twenty-two of the paraneoplastic syndromes involved the endocrine system, 21 were dermatologic or cutaneous, 8 neurologic, 5 osteoarticular or rheumatologic, 1 ocular, 1 muscular, and 1 hematologic. Treatment strategies included surgery, radiotherapy, chemotherapy, and often multimodal therapy, depending on the histology and stage of the laryngeal cancer. CONCLUSIONS Because of their rarity, paraneoplastic syndromes associated with laryngeal cancer are difficult to diagnose. By presenting and systematically reviewing all published cases in the international literature, the present review may help clinicians to recognize them and to suspect the diagnosis of laryngeal cancer at an earlier stage than otherwise might be possible.
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Affiliation(s)
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
| | - Carl E Silver
- Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy.
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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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Pavan Kumar L, Armugham N, Rama Krishna M, Triveni B. Small-Cell Neuroendocrine Tumor of Larynx: A Rare Presentation. Indian J Otolaryngol Head Neck Surg 2019; 71:5-10. [PMID: 31741918 DOI: 10.1007/s12070-015-0866-z] [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: 02/13/2015] [Accepted: 05/30/2015] [Indexed: 10/23/2022] Open
Abstract
Here we report a 60 year aged male presented with complaints of right neck swelling of 3 months duration, swelling was initially small in size and gradually increasing. On examination right level II, hard mobile lymph node was palpable measuring 4 × 4 cm in size, oral cavity and oropharynx was normal. Computed tomography of face neck showed moderately enhancing soft tissue mass of 2 × 3 cm in the supra glottis and left level II cervical lymphadenopathy of size 5 × 5 cm with infiltrating into left sternomastoid muscle. Direct laryngoscopy revealed an ulcero proliferative growth in the supra glottis extending into vallaculla biopsy from the growth showed small round cells with scant amount of cytoplasm with hyperchromatic nucleus, atypical mitosis and at places rosettoid arrangement was seen. Immunohistochemistry with pancytokeratin, CD 56 and synaptophysin were positive, LCA was negative and Ki 67 was >70 %, features consisted with neuroendocrine carcinoma small cell type. Computed tomography of chest, abdomen and pelvis was normal. Finally it was labeled as localized neuro endocrine carcinoma small cell type of larynx (supraglottis). This patient treated with external beam radiotherapy 70 Gy in 35 fractions @ 2 Gy per fraction over 7 weeks along with concurrent chemotherapy with weekly cisplatin followed by adjuvant chemotherapy with Cisplatin and Etoposide for six cycles.
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Affiliation(s)
- Lachi Pavan Kumar
- Department of Radiation Oncology, MNJIO & RCC, Hyderabad, 500082 India
| | - N Armugham
- Department of Radiation Oncology, MNJIO & RCC, Hyderabad, 500082 India
| | - M Rama Krishna
- Department of Radiation Oncology, MNJIO & RCC, Hyderabad, 500082 India
| | - B Triveni
- Department of Pathology, MNJIO & RCC, Hyderabad, India
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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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Chai L, Ying HF, Wu TT, Zhou SH, Bao YY, Yao HT, You QH. Clinical features and hypoxic marker expression of primary sinonasal and laryngeal small-cell neuroendocrine carcinoma: a small case series. World J Surg Oncol 2014; 12:199. [PMID: 24980293 PMCID: PMC4083367 DOI: 10.1186/1477-7819-12-199] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 06/12/2014] [Indexed: 12/11/2022] Open
Abstract
Background Small-cell neuroendocrine carcinoma (SCNEC) of the head and neck is rare. The prognosis of SCNEC in the nasal cavity and larynx is poor. The aim of this study was to investigate the clinicopathological features of nasal and laryngeal SCNEC and to determine the expression of HIF-1α, GLUT-1, PI3K, and p-Akt in SCNEC. Methods Between 2003 and 2012, 10 consecutive patients with histologically demonstrated nasal and laryngeal SCNEC were enrolled. Clinicopathological materials and follow-up data were analyzed retrospectively. Immunohistochemistry was used to detect GLUT-1, HIF-1α, PI3K, and p-Akt expression in paraffin wax-embedded tumor specimens. Results The subjects were eight males and two females with a mean age of 60.8 (range: 53 to 71) years. Tumors were located in the maxillary sinus (n = 3) and larynx (n = 7). At last follow-up, four patients (40.0%) had local recurrence and five patients (50.0%) had developed distant metastases. Six patients died. The mean overall survival was 19.3 ± 2.1 months. Expression of GLUT-1, HIF-1α, PI3K, and p-Akt was seen in sinonasal and laryngeal SCNEC in 80 (8 out of 10), 50 (5 out of 10), 40 (4 out of 10), and 40% (4 out of 10) of cases, respectively. Expression of GLUT-1, HIF-1α, PI3K, and p-Akt was higher in sinonasal and laryngeal SCNEC than in precancerous lesions. Conclusions Primary sinonasal and laryngeal SCNEC is rare. This paper presents 10 cases of sinonasal and laryngeal SCNEC with more common local recurrence and distant metastasis. HIF-1α, GLUT-1, PI3K, and p-Akt expression was higher in sinonasal and laryngeal SCNEC than in precancerous lesions.
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Affiliation(s)
| | | | | | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou City, Zhejiang Province 310003, China.
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Rodrigues IA, Gresta LT, Cruz RC, Carvalho GG, Moreira MHCBQ. Bazex syndrome. An Bras Dermatol 2014; 88:209-11. [PMID: 24346922 PMCID: PMC3876009 DOI: 10.1590/abd1806-4841.20132488] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/01/2013] [Indexed: 11/21/2022] Open
Abstract
Acrokeratosis Paraneoplastica or Bazex syndrome is a dermatologic manifestation
usually associated with the diagnosis of squamous cell carcinoma of the upper
aerodigestive tract. We report a case with exuberant clinical manifestations,
exemplifying the typical cutaneous lesions in this rare syndrome, in a patient with
squamous cell carcinoma of the esophagus.
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Tian H, Chen Z, Wang C, Xing G. Hypopharyngeal paraganglioma with a paraneoplastic neurologic syndrome: a case report. Head Neck 2012; 35:E304-7. [PMID: 22987597 DOI: 10.1002/hed.23164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND We report an extremely rare case of hypopharyngeal paraganglioma that was accompanied by a paraneoplastic neurologic syndrome (PNS). METHODS The clinical, radiological, and histopathologic findings of the patient are presented. RESULTS A 49-year-old woman presented with a history of progressive asthenia of the lower extremities persisting for 2 months. She also experienced numbness and sensory disturbance of the left lower limbs, 2 epileptic seizures, and constipation during the period. Clinical and radiological evaluations suggested the diagnosis of encephalomyelitis in combination with a left hypopharyngeal mass lesion. The patient underwent surgical excision of the lesion, which subsequently resolved her symptoms. Postoperative pathology was consistent with a paraganglioma. There was no evidence of local recurrence or distant metastasis of the tumor on recent follow-up. CONCLUSIONS To the best of our knowledge, our patient represents the third reported case of hypopharyngeal paraganglioma, and the only one to have a paraneoplastic syndrome.
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Affiliation(s)
- Huiqin Tian
- Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
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9
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Fedorchuk OG, Pyaskovskaya OM, Skivka LM, Gorbik GV, Trompak OO, Solyanik GI. Paraneoplastic syndrome in mice bearing high-angiogenic variant of Lewis lung carcinoma: Relations with tumor derived VEGF. Cytokine 2012; 57:81-8. [DOI: 10.1016/j.cyto.2011.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 10/27/2011] [Accepted: 10/31/2011] [Indexed: 01/22/2023]
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10
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Lewis JS, Ferlito A, Gnepp DR, Rinaldo A, Devaney KO, Silver CE, Travis WD. Terminology and classification of neuroendocrine neoplasms of the larynx. Laryngoscope 2011; 121:1187-93. [PMID: 21557244 DOI: 10.1002/lary.21790] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To review the history and literature on neuroendocrine neoplasms of the larynx and discuss the terminology and classification of these tumors. STUDY DESIGN Contemporary review. METHODS Published journal articles identified through PubMed and conference proceedings were reviewed. RESULTS Neuroendocrine neoplasms of the larynx include both epithelial (carcinomas) and neural-type lesions (paragangliomas).The nomenclature of these tumors has changed quite a bit over time, but recently, clearer categories have emerged that are biologically meaningful. They can overlap clinically and histologically so that segregation into the clinically relevant subtypes can be difficult, but it is extremely important to do so as they have a wide range of behaviors going from benign to rapidly fatal. CONCLUSIONS Neuroendocrine neoplasms of the larynx can be clearly categorized into the five tumor types: typical carcinoid, atypical carcinoid, small cell neuroendocrine carcinoma, large cell neuroendocrine carcinoma, and paraganglioma. These have concrete biologic and clinical significance and clearly dictate patient treatment.
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Affiliation(s)
- James S Lewis
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
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Mathew DG, Rooban T, Janani V, Joshua E, Rao U, Ranganathan K. Review of paraneoplastic syndromes associated with oropharyngeal squamous cell carcinoma. J Oral Maxillofac Pathol 2011; 14:41-7. [PMID: 21731261 PMCID: PMC3125058 DOI: 10.4103/0973-029x.72499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Malignancies are usually preceded by the presence of various paraneoplastic syndromes (PNS), which could be the indirect and/or remote effects of the metabolites produced by neoplastic cells. PNS manifested by oropharyngeal squamous cell carcinomas, which is the most common head and neck malignancy, are highlighted in this review. Knowledge of the clinical spectrum of these syndromes will equip the oral physician for early diagnosis and management of these hidden malignancies, especially of the pharyngeal region.
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Affiliation(s)
- Deepu George Mathew
- Department of Oral and Maxillofacial Pathology, Ragas Dental College, Chennai, India
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Ferlito A, Silver CE, Bradford CR, Rinaldo A. Neuroendocrine neoplasms of the larynx: an overview. Head Neck 2010; 31:1634-46. [PMID: 19536850 DOI: 10.1002/hed.21162] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Neuroendocrine neoplasms of the larynx are rare but are the most common nonsquamous tumors of this organ. In the past, there has been considerable confusion about the nature and classification of these neoplasms, but the current consensus is that there are 4 different types of laryngeal neuroendocrine tumors composed of paraganglioma, typical carcinoid, atypical carcinoid tumor, and small cell neuroendocrine carcinoma. Carcinoids and small cell neuroendocrine carcinomas are epithelial neoplasms, whereas paragangliomas are of neural origin. Diagnosis is based primarily on light microscopy and confirmed by immunohistochemistry and electron microscopy. Precise diagnosis is essential because the natural history, treatment, and prognosis vary widely for the different neoplastic categories. Typical carcinoids are very rare and are treated by wide local excision, usually partial laryngectomy, without elective neck dissection. Atypical carcinoid tumors are more common and more aggressive. They are treated by partial or total laryngectomy with elective or therapeutic neck dissection. Adjuvant chemo/radiotherapy may be of benefit in some cases. Small cell neuroendocrine carcinomas are highly aggressive and should be considered disseminated at initial diagnosis. The treatment is by irradiation and chemotherapy as surgery has proven to be of a little benefit. Paragangliomas are treated by local excision or partial laryngectomy. It is difficult to determine the valid survival statistics for typical carcinoids because of their rarity and confusion in the literature with their atypical counterparts. They have a greater tendency to metastasize, and thus a worse prognosis than was previously believed. Atypical carcinoid tumors have a 5-year survival rate of approximately 50%, which decreases with time. The prognosis of small cell neuroendocrine carcinoma of the larynx is dismal, with 5-year survival rates of 5%. The biological behavior of laryngeal paraganglioma is generally benign and the prognosis is excellent.
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Affiliation(s)
- Alfio Ferlito
- Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy.
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Toro C, Rinaldo A, Silver CE, Politi M, Ferlito A. Paraneoplastic syndromes in patients with nasopharyngeal cancer. Auris Nasus Larynx 2008; 36:513-20. [PMID: 19111998 DOI: 10.1016/j.anl.2008.10.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Revised: 09/08/2008] [Accepted: 10/14/2008] [Indexed: 11/17/2022]
Abstract
Paraneoplastic syndromes (PNS) represent the clinical manifestation of the remote and indirect effects produced by tumor metabolites or other products. Paraneoplastic effects are not directly mediated by tumor invasion of normal tissue, or by the disruption of normal function of the involved organ, or by distant metastases. More than 260 cases of nasopharyngeal carcinoma (NPC) associated with PNS have been reported in the literature. These syndromes can be divided into six main groups: cutaneous or dermatologic, endocrine, hematologic, osteoarticular or rheumatologic, neurologic, and ocular. The most common dermatologic manifestation is dermatomyositis, while the syndrome of inappropriate secretion of antidiuretic hormone and occasionally Cushing's syndrome due to ectopic ACTH production are the endocrinologic manifestations. Tumor fever and leukemoid reaction, osteoarticular or rheumatic syndromes, including clubbing of the fingers and toes, sensory neuropathy and demyelinating motor polyneuropathy, and rarely optic neuritis represent the most prominent examples of the other groups of syndromes. PNS may occur before the NPC is manifest, or while it is in an occult stage, and thus the possibility of NPC should be considered in patients with these various disorders. While some PNS will respond to direct treatment, most often the PNS subsides in parallel to response of the NPC, and thus may be useful for monitoring tumor response or recurrence.
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Affiliation(s)
- C Toro
- Department of Surgical Sciences, Maxillofacial Surgery Clinic, University of Udine, Italy
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Ferlito A, Rinaldo A. Primary and secondary small cell neuroendocrine carcinoma of the larynx: A review. Head Neck 2008; 30:518-24. [DOI: 10.1002/hed.20797] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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