Pierce S T, Cibull M L, Metcalfe M S, Sloan D
Department of Internal Medicine, University of Kentucky Medical Center, Lexington 40536-0084.
Head Neck. 1994 May-Jun;16(3):266-71. doi: 10.1002/hed.2880160310.
Primary small cell carcinoma of the head and neck is rare. Although the larynx is the most prevalent site of head and neck small cell carcinoma (SCC), this report will concentrate on SCC of the major salivary glands and paranasal sinuses. In all, 33 cases of paranasal sinus and 43 cases of major salivary gland SCC have been reported in the literature.
We report two patients, one with submandibular gland SCC and the other with maxillary sinus SCC. A literature review of all known paranasal sinus and major salivary gland SCC with inclusion of data from these two new cases is undertaken. Discussion of all past and present cases concentrates on sites of metastasis, treatment, and survival.
Paranasal sinus SCCs predominantly arise from the nasal cavity, whereas the parotid gland is the primary site in three fourths of major salivary gland SCCs. One half of major salivary gland and three fourths of paranasal sinus SCCs have only local disease at presentation. Both patients in this report developed bone marrow metastases, a feature heretofore not observed in SCC from these primary sites. The patient with maxillary sinus SCC developed the syndrome of inappropriate antidiuretic hormone (SIADH).
The paranasal sinus and major salivary glands are rare primary sites for SCCs. Long-term survival with local therapy in patients with local disease can occur, but in patients with metastatic disease survival mirrors metastatic pulmonary SCC.
头颈部原发性小细胞癌较为罕见。虽然喉是头颈部小细胞癌（SCC）最常见的发病部位，但本报告将重点关注大唾液腺和鼻窦的SCC。文献中总共报道了33例鼻窦SCC和43例大唾液腺SCC。
我们报告了两名患者，一名患有下颌下腺SCC，另一名患有上颌窦SCC。对所有已知的鼻窦和大唾液腺SCC进行文献综述，并纳入这两个新病例的数据。对所有既往和目前病例的讨论集中在转移部位、治疗和生存情况。
鼻窦SCC主要起源于鼻腔，而在四分之三的大唾液腺SCC中，腮腺是原发部位。一半的大唾液腺SCC和四分之三的鼻窦SCC在初诊时仅为局部病变。本报告中的两名患者均发生了骨髓转移，这是这些原发部位的SCC迄今未观察到的特征。上颌窦SCC患者出现了抗利尿激素分泌不当综合征（SIADH）。
鼻窦和大唾液腺是SCC罕见的原发部位。局部病变患者通过局部治疗可实现长期生存，但转移性疾病患者的生存情况与转移性肺SCC相似。
