Kayhan Fatma Tülin, Başaran Efser Gürer
Bakırköy Dr, Sadi Konuk Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey.
J Med Case Rep. 2010 Oct 12;4:321. doi: 10.1186/1752-1947-4-321.
Neuroendocrine tumors are the second most common neoplasms of the larynx. Histopathologically, neuroendocrine tumors can be classified into four types: typical carcinoid tumors, atypical carcinoid tumors, small cell neuroendocrine tumors and paragangliomas. Typical carcinoid tumor of the larynx is a particularly rare occurrence. We present a case of this rare disease, and review and discuss its diagnosis and treatment.
A 55-year-old Turkish woman presented with a two-year history of persistent hoarseness. Endoscopic laryngeal examination and computed tomography revealed a supraglottic mass. Direct laryngoscopy was performed and a biopsy taken. Results of the histopathologic examination and immunohistochemical analysis were consistent with typical carcinoid tumor of the larynx. A supraglottic laryngectomy was performed. There was no recurrence during a follow-up period of three years.
Carcinoid tumors require an accurate diagnosis because of their varied clinical behavior and prognosis. A correct pathologic diagnosis is essential, differentiating the tumors from other neuroendocrine neoplasms and medullary cancer of the thyroid gland. Immunohistochemical analysis is supplementary to a standard histopathologic evaluation. Currently, conservative surgical resection without elective neck dissection is the recommended treatment for typical carcinoid tumor of the larynx. Additional cases and case series with long-term follow-up will be useful for understanding the nature of this tumor and should clarify the prognosis.
神经内分泌肿瘤是喉部第二常见的肿瘤。在组织病理学上,神经内分泌肿瘤可分为四种类型:典型类癌肿瘤、非典型类癌肿瘤、小细胞神经内分泌肿瘤和副神经节瘤。喉部典型类癌肿瘤极为罕见。我们报告一例这种罕见疾病,并对其诊断和治疗进行回顾与讨论。
一名55岁的土耳其女性有持续两年的声音嘶哑病史。喉镜检查和计算机断层扫描显示声门上区有肿物。进行了直接喉镜检查并取了活检。组织病理学检查和免疫组化分析结果与喉部典型类癌肿瘤一致。实施了声门上喉切除术。在三年的随访期内未出现复发。
类癌肿瘤因其多样的临床行为和预后需要准确诊断。正确的病理诊断至关重要,可将此类肿瘤与其他神经内分泌肿瘤及甲状腺髓样癌区分开来。免疫组化分析是对标准组织病理学评估的补充。目前,对于喉部典型类癌肿瘤,推荐采用不进行选择性颈清扫的保守性手术切除。更多病例及长期随访的病例系列将有助于了解该肿瘤的性质,并应能明确其预后。