Long-term disease-free survival in patient with laryngeal small cell neuroendocrine carcinoma: A case report and literature review / 吉林大学学报(医学版)

ABSTRACT

Objective: To analyze the clinical characteristics of patient with laryngeal small cell neuroendocrine carcinoma (LSCNC) with long-term disease-free survival, and to provide the basis for the diagnosis and treatment of LSCNC. Methods: The clinical materials of a patient with primary LSCNC were collected, and the clinical features, diagnosis and treatment of LSCNC and extrapulmonary small cell cancer (EPSCC) combined with the relative literatures were analyzed. Results: The patient was a 55-year-old man who had a long history of heavy smoking and drinking, and presented with neck mass. The laryngoscope revealed the uneven mass on the left side of epiglottic laryngeal surface. The subsequent biopsy of the neck mass indicated lymph node metastasis. The patient underwent laryngectomy and bilateral cervical lymph node dissection. The postoperative pathology indicated LSCNC; the immunohistochemistry results showed CD56 (NK-1) (+), CK-pan (+), CgA (-), Syn (-) and Ki-67 (+ 90%). The patient underwent radiotherapy to the tumor bed and lymph node drainage area and 6 courses of chemotherapy with EP regimen. No prophylactic cranial irradiation (PCI) was conducted. Regular follow-up with laryngoscope, crainial MRI and other examinations showed no recurrence and metastasis. The patient still alive with disease-free survival of 38 months now. Conclusion: LSCNC is highly malignant. The diagnosis mainly depends on the pathohistomorphology and immunohistochemistry examination. The combination of surgery, chemotherapy and radiotherapy is commonly used for LSCNC at present. PCI is not recommended routinely. Multimodality treatment can improve the prognosis.