下咽大细胞神经内分泌癌:一个独特的组织病理学实体

M. Shakeel
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摘要

目的:报告1例累及下咽的大细胞神经内分泌癌(LCNEC)的病理诊断、影像学检查及肿瘤治疗。病例报告:一名71岁的白人男性,有4个月的右侧喉咙痛病史,1个月的喉部感觉有东西卡在喉咙,伴有较深的声音,2周的右侧指痛症病史。经检查,他的声音粗哑,但没有喘气。右颈II级可触及2 × 2 cm淋巴结。软性咽镜检查显示右半声门襞外生性生长,覆盖整个声门。然而,全内窥镜显示一个巨大的外生肿块填满了右侧梨状窝,并累及邻近的动脉瓣襞和环后区。活检证实为LCNEC,细针穿刺细胞学检查显示颈部转移。扫描检查未显示他体内有任何广泛的疾病。他在多学科团队环境中进行管理,并接受放化疗治疗。结论:LCNEC累及下咽是一种极为罕见的临床疾病,预后较差。早期诊断和放化疗的根治性治疗似乎是一种可接受的治疗选择。
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Large Cell Neuroendocrine Carcinoma of Hypopharynx: a distinct histopathological entity
Aim: To present a case of large cell neuroendocrine carcinoma (LCNEC) involving the hypopharynx focusing on the histopathological diagnosis, radiological investigations and oncology treatment. Methodology: A case report with relevant literature review Case report: A 71-year-old Caucasian male presented with a four-month history of right sided sore throat, a one-month history of feeling something stuck in his throat at the level of the larynx associated with a deeper voice and two weeks history of right referred otalgia. On examination his voice has a rough but there was no stridor. There was a 2 x 2 cm node palpable in the right neck level II. Flexible pharyngolaryngoscopy revealed an exophytic growth on the right aryepiglottic fold that was covering the whole of the glottis. However, panendoscopy showed a large exophytic mass filling up the right piriform fossa involving the adjacent aryepiglottic fold and the postcricoid region. The biopsy confirmed the LCNEC and the fine needle aspiration cytology showed metastasis in his neck. The scans did not show any widespread disease in the body. He was managed in the multidisciplinary team setting and was treated with chemoradiotherapy. Conclusion: LCNEC involving the hypopharynx is an extremely rare clinical entity with poor prognosis. Early diagnosis and radical treatment with chemoradiotherapy would appear to be an acceptable treatment option.
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