Small cell carcinoma arises most commonly in the lungs and rarely in the larynx. Since no therapeutic strategy for small cell carcinoma of the larynx has been established yet, chemotherapy, radiotherapy, and/or surgery are selected by reference to the principles of treatment of small cell carcinoma of the lung. The prognosis of small cell carcinomas has been reported to be poor because of the propensity of these tumors to show rapid progression and metastasize early. We report a patient with primary small cell carcinoma of the larynx who was treated by surgery and survived for more than 5 years after the surgery.
A 76-year-old man presented to a previous medical facility complaining of pharyngeal pain. A tumorous lesion was found on the left of the epiglottis, and a biopsy of the lesion was performed by laryngeal microsurgery at the previous medical facility. As the histopathology revealed findings suspicious for small cell carcinoma, the patient was referred to our department. PET-CT showed no evidence of distant metastasis, and there was no obvious accumulation in the primary tumor. Based on the findings, the patient was diagnosed as having carcinoma of the epiglottis, cT1N0M0. A transoral videolaryngoscopic surgery (TOVS) was performed to completely resect the epiglottic tumor under general anesthesia.
Postoperative histopathology revealed small tumor cells resembling plasmacytes with ubiquitous subepithelial nuclei and small follicular proliferations, and positive immunohistochemical staining of the tumor cells for chromograninA, synaptophysin, CD56, AE1/AE3, and p40. Based on the findings, the tumor was definitively diagnosed as a neuroendocrine carcinoma, small cell type. The patient showed no evidence of any recurrence for more than 5 years after the surgery even in the absence of any additional treatments. In this case, early detection and surgical intervention in the early stage led to long-term survival of the patient. Surgical treatment is suggested to be effective in patients with primary small cell carcinoma of the larynx when the lesions are in the early stage and limited, without metastasis.
