"Composite" tumor--mixed squamous cell and small-cell anaplastic carcinoma of the larynx

Mixed squamous and oat cell carcinomas (composite neoplasms) of the larynx behave aggressively with a propensity toward early dissemination. Diagnosis may not be made until definitive surgery is performed. The extent of surgery must be determined by the size and site of the primary neoplasm and the physiologic status of the patient. In our experience, surgery has adequately controlled the primary disease. A metastatic work-up is essential. Entry into a comprehensive program employing adjunctive radiotherapy and chemotherapy are strongly recommended. Theories concerning histogenesis remain controversial and include two separate colliding tumors, differentiation from a single cell line, or divergent differentiation of a single cell line.