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Primary Tonsillar Small Cell Neuroendocrine Carcinoma with Bone Metastases
Nik-Mohd-Syahrul-Hafizzi Awang1, Ali Haron2, Baharudin Abdullah1
1Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Iranian Journal of Otorhinolaryngology
|August 29, 2022
Summary
Small cell neuroendocrine carcinoma (NEC) is a rare tonsil cancer with a poor prognosis due to aggressive behavior and metastasis. This case highlights diagnosis and discusses potential future treatments for this uncommon head and neck carcinoma.
Area of Science:
- Oncology
- Head and Neck Surgery
- Pathology
Background:
- Small cell neuroendocrine carcinoma (NEC) is a rare malignancy, predominantly originating in the bronchopulmonary system.
- Extrapulmonary NEC, particularly in the head and neck region like the tonsil, represents a diagnostic and therapeutic challenge due to its rarity.
Observation:
- A patient presented with painless neck swelling and tonsillar hypertrophy, indicative of a rapidly progressing malignancy.
- Imaging revealed tumor extension into the parapharyngeal space and metastasis to the thoracolumbar spine.
- Histopathological examination of the tonsil confirmed primary small cell neuroendocrine carcinoma.
Findings:
- The case underscores the aggressive nature of tonsillar NEC, characterized by rapid growth and distant metastasis.
- Diagnostic workup involved clinical presentation, computed tomography, and intraoral biopsy for definitive histopathological diagnosis.
Implications:
- The rarity of tonsillar NEC necessitates a thorough understanding of its characteristics for effective management.
- While definitive treatments are lacking, advancements in chemotherapy and radiotherapy may offer improved therapeutic strategies in the future.
- This case contributes to the limited literature on extrapulmonary NEC, aiding in the comprehension of its clinical behavior and management.
