A review of neuroendocrine neoplasms of the larynx: update on diagnosis and treatment

1998 ◽  
Vol 112 (9) ◽  
pp. 827-834 ◽  
Author(s):  
Alfio Ferlito ◽  
Leon Barnes ◽  
Alessandra Rinaldo ◽  
Douglas R. Gnepp ◽  
Christopher M. Milroy
Keyword(s):  
Lymph Node ◽  
Neck Dissection ◽  
Conservative Surgery ◽  
Small Cell ◽  
Elective Neck Dissection ◽  
Neuroendocrine Neoplasms ◽  
Atypical Carcinoid ◽  
Cell Type ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Node Metastases

AbstractNeuroendocrine neoplasms of the larynx have been divided into those of epithelial or neural origin. The latter consist of paragangliomas while the epithelial origin group can be divided into the typical and atypical carcinoids and small cell neuroendocrine carcinomata, the latter consisting of the oat cell type, the intermediate cell type and the combined cell type. There are now over 500 cases of neuroendocrine neoplasms of the larynx in the literature.The diagnosis is primarily based on light microscopy, and, in some instances, it may be supported by special histochemical studies. It should be confirmed by immunocytochemical and/or ultrastructural investigation. The different biological behaviour of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on diagnostic accuracy.Typical carcinoid is an extremely rare lesion. It is treated preferably by conservative surgery; elective neck dissection is not necessary because of the lack of lymph node metastases at diagnosis. Chemotherapy and/or radiotherapy have not been effective in the limited number of patients treated thus far. Prognosis is excellent with cure following surgery.Atypical carcinoid is the most frequent non-squamous carcinoma of the larynx. The mainstay of treatment is surgery. Elective neck dissection should be performed because of the high likelihood of cervical lymph node metastases. Primary radiation therapy with adjuvant chemotherapy is not indicated. The survival rate is 48 per cent at five years and 30 per cent at 10 years.Although the larynx is one of its most common extrapulmonary sites, small cell neuroendocrine carcinoma is still a rare tumour. Surgical results for this tumour have been disappointing and is reserved for cases of local relapse with no evidence of metastasis. Chemotherapy and radiotherapy currently appear to offer the least disabling and most effective forms of therapy. The two- and five-year survival rates are 16 per cent and five per cent, respectively.Paraneoplastic syndromes have occasionally been reported in association with carcinoid tumours (typical and atypical) and small cell neuroendocrine carcinoma. There have been also rare reports of an elevated neuropeptide serum level.Paraganglioma is the only laryngeal neuroendocrine neoplasm with a female preponderance (3:1). Confusion with atypical carcinoid has led to incorrect diagnosis and inappropriate classification schemes, erroneously suggesting that laryngeal paraganglioma has the potential for aggressive behaviour. Conservative surgery represents the treatment of choice; elective neck dissection is not necessary, and the prognosis is excellent.

scholarly journals Neuroendocrine tumor of larynx: A review of literature

2015 ◽  
Vol 01 (01) ◽  
pp. 033-036 ◽  
Author(s):  
L Kumar ◽  
N Armugham ◽  
B Triveni ◽  
M Krishna
Keyword(s):  
Neck Dissection ◽  
Local Excision ◽  
Small Cell ◽  
Elective Neck Dissection ◽  
Neuroendocrine Neoplasms ◽  
Partial Laryngectomy ◽  
Atypical Carcinoid ◽  
Typical Carcinoid ◽  
Precise Diagnosis ◽  
Neuroendocrine Carcinomas

AbstractNeuroendocrine neoplasms of the larynx are rare but are the most common nonsquamous tumors of this organ. 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.

Morphological and immunohistochemical study of typical and atypical carcinoids of the lung with clinico-pathological correlation

1994 ◽  
Vol 1 (4) ◽  
pp. 53-62 ◽  
Author(s):  
H Klemen ◽  
F M Smolle-Jüttner ◽  
H H Popper
Keyword(s):  
Lymph Node ◽  
Survival Data ◽  
Vascular Invasion ◽  
Mitotic Rate ◽  
Small Cell ◽  
Atypical Carcinoid ◽  
Nuclear Pleomorphism ◽  
Structural Pattern ◽  
Node Metastases ◽  
Neuroendocrine Carcinomas

ABSTRACT Typical and atypical carcinoids are neuroendocrine epithelial lung tumours which are difficult to distinguish. Confusion has been introduced by designating atypical carcinoids as well differentiated neuroendocrine carcinomas and including some tumours which are large cell neuroendocrine carcinomas. We therefore investigated 32 typical and 23 atypical carcinoids of the lung, and 9 combined forms of atypical carcinoid and small cell carcinoma. The following parameters were each independently correlated in a multivariate analysis with 10-year survival data: nuclear and nucleolar polymorphism, mitotic counts, vascular invasion, lymph node metastasis, structural pattern, location of the tumours, immunohistochemistry, age and sex of the patients. Typical carcinoids were characterized by an absence of vascular invasion and lymph node metastases, and a mean mitotic rate of 0.75/10 high power fields (HPFs), while atypical carcinoids were characterized by vascular invasion and/or metastases, a mean mitotic rate of 4.25/10 HPFs and nuclear pleomorphism. Combined forms of atypical carcinoid and small cell carcinoma were characterized by vascular invasion, metastases and a mean mitotic rate of 20.7/10 HPFs. Vascular invasion, lymph node metastases, mitotic counts and nuclear pleomorphism significantly correlated with 10-year survival data, whereas location, size and structural pattern of the tumour, age and sex did not correlate with survival. All tumours were positive for cytokeratins and at least two out of three general neuroendocrine markers. However, positive reactivity for different peptides, hormones, and neurotransmitters did not correlate with one of the structural subtypes of carcinoid or with patient survival.

Clinical Predictors of Metastatic Disease to the Brain from Non–Small Cell Lung Carcinoma: Primary Tumor Size, Cell Type, and Lymph Node Metastases

Radiology ◽  
2007 ◽  
Vol 242 (3) ◽  
pp. 882-888 ◽  
Author(s):  
Amol Mujoomdar ◽  
John H. M. Austin ◽  
Rohin Malhotra ◽  
Charles A. Powell ◽  
Gregory D. N. Pearson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Cell Type ◽  
Small Cell Lung ◽  
Clinical Predictors ◽  
Cell Lung Carcinoma ◽  
Primary Tumor Size ◽  
Node Metastases ◽  
The Brain

Chemical Anaplasia in Atypical Debut of Non-small Cell Lung Cancer with Inguinal and Obturator Lymph Node Metastases

2018 ◽  
Vol 69 (10) ◽  
pp. 2833-2836
Author(s):  
Laura Rebegea ◽  
Aurel Nechita ◽  
Cristina Serban ◽  
Camelia Diaconu ◽  
Luana Andreea Macovei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lymph Node Metastases ◽  
Palliative Chemotherapy ◽  
Small Cell ◽  
Lumbar Region ◽  
Small Cell Lung ◽  
Node Metastases

Non-small cell lung cancer (NSCLC) represents almost 80-85% of lung cancer cases. It is the most frequent malignancy after skin cancer. The therapeutic options for stage IV of disease consider histology, molecular characteristics, age, performance status, comorbidities, and not in the lust, patient�s option. This paper presents the case of a male patient, 73 years old, smoker, presented and treated in May 2016 in the Sf. Ap. Andrei Emergency Clinical Hospital Galati. The first sign of disease was inguinal and obturator right lymph node metastases whose histopathological test revealed metastases from malignant melanoma. Immunohistochemical tests (IHC) indicated undifferentiated carcinoma with lung as starting point, (Ck7 (+), TTF1 (+)). Thorax, abdominal and pelvic computed tomography (CT) imaging not evidenced space replacement processes in lung, but with mediastinal, right obturator and inguinal adenopathy. From personal pathological history we retain basocellular carcinoma in lumbar region, treated with surgery in 2009. It was initiated palliative chemotherapy and radiotherapy with remission of obturator and inguinal adenopathy, and at 9 months from diagnosis the Positron Emission Tomography (PET-CT) evidenced primary lung tumor situated in right superior lobe (RSL). At the present, patient is alive performing palliative chemotherapy. This case presented diagnostic and treatment issues, being a challenge for multidisciplinary team. We are mentioning the paucity of literature data regarding cases of primary tumors situated upper diaphragm which metastases in inguinal lymph nodes.

Overexpression of SLC1a5 in lymph node metastases outperforms assessment in the primary as a negative prognosticator in non-small cell lung cancer

Pathology ◽  
2018 ◽  
Vol 50 (3) ◽  
pp. 269-275 ◽  
Author(s):  
Agnes Csanadi ◽  
Annika Oser ◽  
Konrad Aumann ◽  
Vera Gumpp ◽  
Justyna Rawluk ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lymph Node Metastases ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastases

scholarly journals Laryngeal Neuroendocrine Carcinomas: A Retrospective Study of 14 Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Yingying Zhu ◽  
Liming Gao ◽  
Yunxiao Meng ◽  
Wenwen Diao ◽  
Xiaoli Zhu ◽  
...  
Keyword(s):  
Survival Time ◽  
Neuroendocrine Carcinoma ◽  
Clinical Manifestations ◽  
Small Cell ◽  
Atypical Carcinoid ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Typical Carcinoid ◽  
Mean Survival Time ◽  
The Mean ◽  
Neuroendocrine Carcinomas

Laryngeal neuroendocrine carcinomas (LNECs) are rare and highly heterogeneous which present a wide spectrum of pathological and clinical manifestations. Fourteen patients with histologically demonstrated LNEC were collected and analyzed retrospectively. The 14 cases were classified into 3 subtypes: typical carcinoid in 2, atypical carcinoid in 5, and small cell neuroendocrine carcinoma in 7. The mean survival time of the 14 patients in this study was 112.5 months (95% CI, 81.5–143.6). Surgeries were performed for 2 patients of typical carcinoid, and they were alive with no evidence of recurrence after 24 and 47 months of follow-ups. Patients in the atypical carcinoid group were treated with surgeries and postoperative radiotherapy. After 58.4 months of follow-ups (range: 9–144), 2 patients showed no evidence of disease and 1 was lost to follow-up after 72 months. The other 2 patients died of other unrelated diseases. In the small cell neuroendocrine carcinoma group, a combination of chemotherapy and radiotherapy was applied. The mean survival time was 79.7 months (95% CI, 37.9–121.4), and the 5-year survival rate was 53.6%. In conclusion, the clinical behaviors, treatment protocols, and prognosis are different for each subtype of LNECs.

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