Undifferentiated Laryngeal Carcinoma with Pagetoid Spread

Abstract

Pagetoid spread, is used to define intraepithelial spread of cancer cells, when a massive carcinoma is identified beneath the basal membrane. There are only few reports of pagetoid spread at the head and neck region. Herein a 74 year old male patient with bilateral transglottic laryngeal high grade malignant epithelial tumor with pagetoid spread is presented. The tumor was located at the submucosa and there was spread of the CK7 and CK19 positive tumor cells into the non neoplastic mucosa, which was CK5/6 positive, sparing the basement membrane, creating a typical pagetoid pattern. Radiographic and positron emission tomography scan examination of the patient was unremarkable at presentation other than the laryngeal and neck lesions; but extensive systemic metastasis developed at 6 months following operation. To the best of our knowledge no epithelial malignancy with pagetoid spread was described at the larynx. Pagetoid spread may be a hallmark of very aggressive behavior in laryngeal carcinoma.There are only a few reports of pagetoid spread at the head and neck region. Herein a 74-year old male patient with bilateral undifferentiated transglottic laryngeal carcinoma with pagetoid spread is presented. The patient developed extensive systemic metastasis at 6 months following operation. Pagetoid spread may be an overlooked hallmark of very aggressive behavior in laryngeal carcinoma.

Unusual case of extramammary Paget disease of the oral mucosa: A case report and literature review

“…Finally, a case of perioral EMPD associated with oral adenocarcinoma was recently reported, although neither immunohistochemical results, oral mucosal involvement, nor the histologic type of underlying adenocarcinoma was reported 21 . Secondary EMPD of nearby mucosal sites has infrequently been reported 22,23 …”

“…21 Secondary EMPD of nearby mucosal sites has infrequently been reported. 22,23 Secondary EMPD portends a poor clinical outcome 6,24 necessitating an extensive search for an underlying malignancy. Immunohistochemistry for CK7, CK20, and GCDFP-15 has been proposed to differentiate primary and secondary EMPD, as primary EMPD is often CK7 + , CK20 À , and GCDFP-15 + .…”

Undifferentiated Carcinoma of the Larynx in a Developing Community

“…A search of the Internet revealed but a few reports on the larynx exhibiting undifferentiated carcinoma. From Turkey [1], a 7-year-old male patient was reported to have "Undifferentiated laryngeal carcinoma with pagetoid spread." From both France [2] and India [3], the authors went as far as to differentiate undifferentiated carcinoma of "nasopharyingeal type."…”