Immunohistochemical Analysis of Small Cell Carcinoma of the Head and Neck: A Report of Four Patients and a Review of Sixteen Patients in the Literature with Ectopic Hormone Production

Abstract

Small cell carcinoma (SCC) occurs mostly in the lung, and in some patients is accompanied by production of ectopic hormones. Small cell carcinoma of the head and neck is very rare. We report 4 patients with SCC of the head and neck (larynx, tonsil, maxillary sinus, and parotid gland). The patient with SCC of the maxillary sinus demonstrated a high level of plasma serotonin and overexpression of parathyroid hormone; however, he did not show any related symptoms. The patient with SCC of the tonsil showed the syndrome of inappropriate secretion of antidiuretic hormone associated with antidiuretic hormone hyperproduction at the terminal stage. In the literature, 16 patients with SCC of the head and neck with ectopic hormone production have been reported. Antidiuretic hormone and adrenocorticotropic hormone were the hormones that caused clinical symptoms (paraneoplastic syndromes). We believe that the evaluation of hormonal syndromes is valuable for diagnosis and treatment.

Small cell neuroendocrine carcinoma of nose and paranasal sinuses: a study of three cases with short review of the literature

“…The association between the paraneoplastic endocrine syndrome and SNEC is well documented [4]. None of the three patients had any endocrine syndrome which is rare in SNECs of head and neck.…”

“…Carcinoid tumours are commonly considered to be well differentiated neuroendocrine carcinomas whereas atypical carcinoid tumours are regarded as moderately differentiated neuroendocrine carcinomas and SNECs are classifi ed as poorly differentiated neuroendocrine carcinomas. These cells contain membrane bound granules in the cytoplasm which can be demonstrated by Grimelius stain [4], electron microscopy [6] and their endocrine differentiation can be demonstrated by immunohistochemistry [4,7]. The tumour cells originate from the basal cells in the olfactory mucosa [8].…”

“…None of the three patients had any endocrine syndrome which is rare in SNECs of head and neck. Review of literature shows only in 5 cases of SNECs of nasal and paranasal sinuses endocrine syndromes have been described [4].…”

“…3B). As H&E staining was not suffi cient to establish diagnosis of SNEC [4], help of immunohistochemistry was taken for confi rmation. The malignant cells showed neuroendocrine differentiation as evidenced by strong positivity with chromogranin (Fig.…”

Moderately Differentiated Neuroendocrine Carcinoma (Atypical Carcinoid) of the Parotid Gland: Report of Three Cases with Contemporary Review of Salivary Neuroendocrine Carcinomas

“…The parotid gland is much more frequently involved than the minor salivary glands [10,31,[37][38][39]. Patient's ages range from nine to 96 years with no racial predilection reported [40,41]. Histologically, tumor cells demonstrate sheets, trabeculae or cords of large pleomorphic, polygonal or fusiform cells measuring [30 l in diameter.…”