臨床病理学ジャーナル

抽象的な

Atypical Carcinoid Tumor of the Larynx: A Challenging Diagnostic Case

Kastoer C, Vanderveken OM, Lammens M, Specenier P, Carp L, Vliet JV, Verfaillie J, Van de Heyning PH and Van Laer CG

Background: Atypical carcinoids are rare neuroendocrine tumors, but they are the most common type of nonsquamous cell laryngeal neoplasms. Recent literature addresses the importance of adequate diagnosis, but lacks consensus in treatment strategy.

Case report: A 69-year-old man presented with dysphagia. Diagnosis of supraglottic hemangioma was based on fiberoptic examination. After treatment with CO2 laser excision histopathological diagnosis stated paraganglioma. Dysphagia recurred after 6 months. (18)F-FDG PET/CT-scan revealed high FDG-uptake at the right aryepiglottic fold. After CO2 laser excision histopathology showed atypical carcinoid. Total laryngectomy and neck dissection was performed to secure tumor-free margins, followed by adjuvant radiotherapy due to lymph node metastases. A month after termination of radiotherapy no lesions were determined by somatostatin receptor scintigraphy.

Conclusion: Personalized management should be based mainly on mitotic rate and locoregional extension. Surgical treatment and lifelong multidisciplinary follow-up is mandatory, while the role of adjuvant therapy remains debatable.