Kashima Kazutaka, Igarashi Takeshi, Fujii Hiroyuki, Fukushima Noriyoshi, Nishino Hiroshi, Kanazawa Takeharu
Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Shimotsuke 329-0498, Japan.
Department of Radiology, Jichi Medical University, School of Medicine, Shimotsuke 329-0498, Japan.
Int J Surg Case Rep. 2024 Nov;124:110356. doi: 10.1016/j.ijscr.2024.110356. Epub 2024 Sep 27.
Moderately differentiated neuroendocrine tumors of the larynx are rare malignant tumors that arise from the submucosa of the larynx, for which surgery is the first-line treatment.
We report a case of moderately differentiated neuroendocrine tumor of the larynx, in which the patient, a 74-year-old man, experienced long-term palliation but an unfortunate outcome of death owing to metastasis. Laryngeal endoscopic examination revealed an elevated submucosal lesion on the laryngeal surface of the epiglottis. Computed tomography and magnetic resonance imaging showed a tumor-like lesion demonstrating a contrasting effect in the submucosa of the epiglottis. A biopsy revealed a moderately differentiated neuroendocrine tumor (formerly called an atypical carcinoid), and a horizontal partial laryngectomy was performed. The patient had a good postoperative course; however, three years and ten months after surgery, he experienced recurrence in the upper gastrointestinal tract and carcinoid syndrome and died four years and three months after the surgery.
The prognosis of laryngeal neuroendocrine tumors remains poor. In this case, local control was possible without irradiation because the resection margins were negative on pathological examination. This case report has been reported in line with the SCARE Criteria.
Long-term follow-up of this type of tumor is necessary, as distant metastasis is likely to affect prognosis. In addition to surgery, effective adjuvant therapies, including molecular targeted therapies, should be established.
喉中分化神经内分泌肿瘤是一种罕见的恶性肿瘤，起源于喉黏膜下层，手术是其一线治疗方法。
我们报告一例喉中分化神经内分泌肿瘤病例，患者为一名74岁男性，长期病情缓解，但因转移导致不幸死亡。喉镜检查显示会厌喉面黏膜下病变隆起。计算机断层扫描和磁共振成像显示会厌黏膜下有一个类似肿瘤的病变，有对比增强效应。活检显示为中分化神经内分泌肿瘤（以前称为非典型类癌），遂行水平部分喉切除术。患者术后恢复良好；然而，术后三年零十个月，他出现上消化道复发和类癌综合征，并于术后四年零三个月死亡。
喉神经内分泌肿瘤的预后仍然很差。在本病例中，由于病理检查切缘阴性，无需放疗即可实现局部控制。本病例报告已按照SCARE标准进行报告。
由于远处转移可能影响预后，对这类肿瘤进行长期随访是必要的。除手术外，应建立包括分子靶向治疗在内的有效辅助治疗方法。
