[Primary small cell carcinomas and metastatic disease in the head and neck]

Extrapulmonary small cell carcinomas are recognized as a clinicopathologic entity distinct from small cell lung cancer. Such carcinomas as primary tumors have been described in several locations in the head and neck although most cases of metastatic tumor in the neck originate from a pulmonary primary. In this report we present a small cell carcinoma of the larynx, metastasis in the parotid gland as the first manifestation of a small cell lung cancer and a small cell carcinoma of the Merkel cell type in a parotid lymph node. Our review of the current literature shows that most small cell carcinomas in the head and neck are extrapulmonary primary tumors. Since histological criteria are the same, a pulmonary neoplasm has to be excluded in every case. The differentiation between a primary head and neck tumor and metastatic disease as well as the location and staging are essential criteria for therapy and prognosis.