Carcinoma of the larynx with mucosubstance production and neuroendocrine differentiation: An ultrastructural and immunohistochemical study

Abstract

Primary neuroendocrine tumors of the larynx appear to be extremely rare. We report a case of well-differentiated neuroendocrine carcinoma arising in the larynx of a 61-year-old white woman. This case was initially diagnosed as a lymph node metastasis in the neck from an unknown primary carcinoma. Extensive workup subsequently revealed that the larynx was the primary site of the tumor. An electron microscopic study of both the primary and metastatic tumors showed numerous neurosecretory-type granules. Immunohistochemical studies revealed positive immunoreactivity against calcitonin, somatostatin, and ACTH. However, the tumor also displayed focal exocrine differentiation and mucosubstance production. The patient underwent a supraglottic laryngectomy and radical neck dissection and was free of tumor 22 months postoperatively.

Atypical Carcinoid Tumor of the Larynx: A Light Microscopic and Ultrastructural Study

“…Numerous dense core granules are invariably present and usually survive 10% formalde¬ hyde paraffin processing, although their limiting membranes may be destroyed by this procedure.36 Den¬ dritic cell processes were prominent in our case and were also described in the one other report where wet tissue was available for study .5 Laryngeal carcinoid tumors, like other neuroendocrine neoplasms, fre¬ quently demonstrate ultrastructural features of divergent, nonneuroendocrine differentiation. Gland forma¬ tions with microvillus linings were seen in our case and that of Paladugu et al 6 Our case also demonstrates cells with abundant tonofilaments, sug¬ gesting squamous differentiation.…”

Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases

“…The literature on NCL is fragmented over numerous case reports and series of small sample size, often with contradicting results, making it difficult to decide on an appropriate treatment strategy. Consequently, physicians facing these tumors often resort to treatment paradigms developed for better known neoplasms (eg, squamous cell carcinoma).…”

Carcinoid tumours of the larynx: Report of two cases

“…It may be difficult to distinguish carcinoids from other tumours of the larynx. In many cases, ours included, the tumour was misdiagnosed on the first histological examination, most commonly as an anaplastic or undifferentiated carcinoma, more rarely as an adenocarcinoma (Paladugu et al, 1982;Weighill et al, 1986). The correct histological diagnosis of carcinoid has usually been obtained only after laryngeal surgery.…”