Poorly differentiated laryngeal neuroendocrine neoplasm with high serum calcitonin level, a case report, with literature review

Abstract

Neuroendocrine neoplasm (NEN) of the larynx consists of 0.6% of laryngeal cancer and is the second most common type after squamous cell carcinoma (SCC). Laryngeal NEN rarely secret calcitonin and should be differentiated from medullary thyroid carcinoma. It makes a diagnostic and therapeutic challenge. We describe a case of a laryngeal NEN with calcitonin hypersecretion. A 59‐year‐old man presented to our clinic with recurrent cough, dysphonia, hoarseness, cervical mass, and significant weight loss. Diagnostic workup showed a supraglottic mass. Biopsy of the lesion revealed large‐cell neuroendocrine neoplasm. Further diagnostic workup showed elevated serum calcitonin level. The patient underwent total laryngectomy, thyroidectomy, and modified radical neck dissection. During his follow‐up, new subcutaneous nodules appeared that were biopsy‐proven metastases. Then adjuvant chemoradiotherapy was performed. Laryngeal NEN with hypersecretion of calcitonin is a rare entity. In patients with elevated serum calcitonin levels and head and neck tumors, it should be considered a differential diagnosis of medullary thyroid carcinoma. As the management and prognosis of these two neoplasms are entirely different.

Poorly differentiated neuroendocrine carcinoma originating in the subglottic larynx: A case report with imm unohistochemical study

“…A 5-year disease-specific survival rate is about100%, 53%, 19%, and 15%, in Well-differentiated NEC, moderately differentiated NEC, small cell NEC, and large cell NEC respectively. 6 In conclusion, the differential diagnosis in a patient with hoarseness, dyspnea, and subglottic mass must consist of NEC. Due to tumor rarity, pathological diagnosis should be confirmed by immunohistochemistry.…”

“…We describe a rare case of laryngeal NEN in subglottic. While many laryngeal NEC found in the supraglottic, in about 60%–96% of casese 6 …”

“…While many laryngeal NEC found in the supraglottic, in about 60%-96% of casese. 6 Although primary NEC are rare, they are the most common non-squamous neoplasm of the larynx. NE neoplasms are categorized into three groups based on histology: Well-differentiated NE tumors (grade 1-3), NEC (Small cell NEC, and large cell NEC), and Mixed NE non-NE neoplasms.…”

“…Furthermore, tumor prognosis differs among various tumor types. A 5‐year disease‐specific survival rate is about100%, 53%, 19%, and 15%, in Well‐differentiated NEC, moderately differentiated NEC, small cell NEC, and large cell NEC respectively 6 …”

Poorly differentiated neuroendocrine carcinoma originating in the subglottic larynx: a case report with immunohistochemical study

“…While many laryngeal neuroendocrine carcinomas found in the supraglottic, in about 60 to 96 percent of casese. 4 Although primary neuroendocrine carcinomas are rare, they are the most common non-squamous neoplasm of the larynx. Based on 2017 WHO Classification of Head and Neck Tumors, neuroendocrine tumors of the larynx are classified as well-differentiated neuroendocrine carcinoma: typical carcinoid; moderately differentiated neuroendocrine carcinoma: atypical carcinoid; poorly differentiated neuroendocrine carcinoma: small and large cell neuroendocrine carcinoma, and paragangliomas which have a neural origin.…”