Clinical Image
Upper Airway Small Cell Carcinoma
Carcinoma de células pequeñas en vías respiratorias superiores
a Department of Otorhinolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
b Department of Pathology and Lab Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
c Department of Otorhinolaryngology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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(B) Chest CT, minIP coronal reconstruction, showing the fistula (thin arrow) from the esophageal lumen to the right intermediate bronchus (thick arrow). Consolidations can also be seen in both lower lobes. (C) Chest CT, axial reconstruction, pulmonary parenchyma window. Due to multiple previous episodes of aspirations, the patient had bilateral pneumonia. 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Photomicrograph (H&E, ×400) (B) shows small cells with hyperchromatic nuclei and scant cytoplasm. Nuclear moulding and crush artefact are present. PET/CT (C, D) showed increased 18F-FDG uptake in the left supraglottis (SUVmax<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.3) and left neck lymph nodes (SUVmax<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4.0).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 50-year-old man, a known heavy smoker for more than 20 years, presented to our clinic with hoarseness for the last 2 months. Indirect laryngoscopy showed a bulging mass over the left false cord (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) without vocal cord immobility. Biopsy of the mass was performed and the pathology diagnosis was small cell neuroendocrine carcinoma (SCNC) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). Chest CT scan, abdomen sonography, and whole body bone scan disclosed no distant metastasis. However, head and neck CT scan suggested an equivocal node over left level II neck, which was confirmed to be metastatic node by PET scan (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C, D) and sono-guided fine needle aspiration.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">SCNC is aggressive malignancy which occurs mostly in the lung. Extrapulmonary SCNC is relatively rare and encompasses 2.5%–5% of the all SCNCs.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Neuroendocrine neoplasms are the most common non-squamous malignancies of the larynx with a predilection for the supraglottis. The survival rate of laryngeal SCNC is similar to pulmonary SCNC, which remains dismal. The extent of the disease rather than tumour size is the independent prognostic factor for survival. Definitive chemoradiotherapy is currently the best form of treatment.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> Surgery is only reserved for loco-regional recurrence without evidence of distant metastasis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1360 "Ancho" => 1667 "Tamanyo" => 350537 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Indirect laryngoscopy (A) shows submucosal bulging mass (asterisk) over the left false cord. Photomicrograph (H&E, ×400) (B) shows small cells with hyperchromatic nuclei and scant cytoplasm. Nuclear moulding and crush artefact are present. PET/CT (C, D) showed increased 18F-FDG uptake in the left supraglottis (SUVmax<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.3) and left neck lymph nodes (SUVmax<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4.0).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Small cell carcinoma of the head and neck: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Renner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.seminoncol.2006.10.024" "Revista" => array:6 [ "tituloSerie" => "Semin Oncol" "fecha" => "2007" "volumen" => "34" "paginaInicial" => "3" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17270660" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: a meta-analysis of 436 reported cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.P. van der Laan" 1 => "B.E. Plaat" 2 => "B.F. van der Laan" 3 => "G.B. Halmos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hed.23666" "Revista" => array:6 [ "tituloSerie" => "Head Neck" "fecha" => "2015" "volumen" => "37" "paginaInicial" => "707" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24596175" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005400000005/v1_201804290447/S1579212918301393/v1_201804290447/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005400000005/v1_201804290447/S1579212918301393/v1_201804290447/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918301393?idApp=UINPBA00003Z" ]
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