[Neuroendocrine carcinomas of the head and neck]

Neuroendocrine carcinomas (NECs) of the head and neck are rare. Between 1980 and 1995, only 163 cases of laryngeal and 30 cases of sinonasal NEC had been reported worldwide. We report two cases of sinonasal NEC. Case 1: A 49-year-old man complaining of left nasal obstruction was admitted to our hospital. A tumor with a tendency to bleed was seen in the left nasal cavity. CT scanning revealed an enhanced mass in the left nasal cavity and both maxillary and ethmoid sinuses. An open biopsy was performed to determine the diagnosis. The diagnosis of NEC was based on light microscopic and immunohistochemical findings. Chemotherapy and radiation were performed, but bone, liver and brain metastasis occurred 15 months after diagnosis and the patient died. Case 2: A 59-year-old man, complaining of right forehead swelling visited our department. CT scanning and MRI revealed that the right ethmoid sinus was filled by a tumor which had invaded the base of the skull. An open biopsy was performed. From the results of light microscopic and immunohistochemical investigations, NEC was highly suspected. Chemotherapy and radiation were performed, but the patient died 6 months after diagnosis. This study shows that there are aggressive types of nasal NEC, although these sinonasal carcinomas were reported in the literature to be not very lethal. The diagnosis, histopathological classification, treatment, and prognosis of sinonasal and laryngeal NECs were reviewed.