Neuroendocrine tumor of larynx: A review of literature

Abstract

Neuroendocrine 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.

Case report of atypical carcinoid tumors of the larynx

“…Glossopharyngeal neuralgia can occur before tumor being clinically clear and the current patient did report pain. 10 Computed tomography of the larynx is Microscopy of atypical carcinoid tumor shows perineural invasion and mitioc figure less than 2/10 HPF which also occur in typical type. Though, besides typical type present better prognosis, they do not present positive signs in the immunohistochemical analysis for CK, chromogranin and synaptophysin and the diagnosis was not questionable due to perineural invasion.…”

Primary neuroendocrine small cell carcinoma in larynx: case report and literature review

“…Cervical lymph nodes, liver, lung, bones and bone marrow are considered the most predisposed sites for metastatic disease. Some researchers believe that small cell neuroendocrine carcinoma of the larynx, much like its lung counterpart, should be viewed as a systemic disease 20 . According to a 2008 publication, using the National Cancer Institute's Surveillance and End Results database, researchers outlined that 5-year survival for small cell carcinoma for specific sites such as glottis and supraglottis was 15% and 24.1%, respectively 21 .…”

Laryngeal Neuroendocrine Neoplasia

“…The treatment of choice for typical carcinoid is total surgical resection, laryngeal conservation surgery is sufficient for small lesion, while total larygectomy is recommended for large invasive tumor. Due to unusual lymph node metastases, neck dissectopn is recommended only for clinical and pathological lymph node, the tumor is resistant to chemoradiotherapy, and prognosis is usually good [4][5][6][7].…”

“…As most tumors are located in supraglottic region, supraglottic laryngectomy is often the procedure of choice for supraglottic location. Elective neck dissection is indicated due to high incidence of early cervical lymph node metastasis [5][6][7][8].…”

“…The chemotherapeutic agents commonly used should not penetrate the blood-brain barrier. Prophylactic cranial irradiation has been recommended as part of the management of this cancer [5][6][7]10]. …”