International Journal of Radiation Oncology*Biology*Physics
Clinical InvestigationSmall Cell Carcinoma of the Head and Neck: The University of Miami Experience
Introduction
Small cell carcinoma of the head and neck is a rare neuroendocrine tumor (1) that can arise from multiple anatomic subsites and carries a poor prognosis. Although some differences in the clinical behavior of tumors arising from different subsites may exist, it is known that small cell carcinoma of the head and neck is aggressive and has a propensity for distant and/or regional spread. Therapeutic management can include surgery, radiotherapy, chemotherapy, or some combination of these modalities. Because of the rarity of these tumors and the extremely small number of single-institution experiences or case reports, no firm recommendations or treatment guidelines can be strictly followed. It is very important to continue to report single-institution experiences of small cell carcinoma of the head and neck, thus disseminating any available information on the treatment and its outcomes of this very rare neuroendocrine tumor. The purpose of our retrospective study was to describe the experience of the University of Miami in treating small cell carcinoma of the head and neck during a 20-year period.
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Methods and Materials
Our institutional review board approved the study. A total of 12 patients with primary nonmetastatic, histopathologically documented, small cell carcinoma of the head and neck involving the parotid gland, oropharynx, nasopharynx, sinonasal cavity, or supraglottic larynx were treated at the University of Miami between April 1987 and September 2007. All patients had undergone a complete workup to rule out distant metastasis or other primary site metastases to the head-and-neck area. The
Results
The demographics, disease characteristics, and treatment received are summarized in Table 1. Of the 12 patients, 7 were men and 5 were women. The median age at presentation was 69.5 years (range, 49–85). Of 10 patients, with a known stage, 8 (80%) had positive regional adenopathy at diagnosis.
The 11 patients who underwent radiotherapy were treated with 6-MV photons, with once-daily radiation dose of 1.8 or 2.0 Gy/fraction. The total dose was 45–70.2 Gy (median, 64.8). No patient received
Discussion
Extrapulmonary small cell carcinomas comprise 2.5–5% of all small cell carcinomas (3). The first case of small cell carcinoma of the head and neck was reported by Olofsson and van Nostrand (4) in 1972 and involved the larynx. Small cell carcinomas of the head and neck are generally considered very aggressive, with a great propensity for local infiltration and regional and diffuse distant metastases.
At diagnosis, more than one-half of patients present with a nodal mass. Moisa (5) reported a 59%
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Rare cases of head and neck's neuroendocrine carcinomas disease: Case series of 4 patients and review of the literature
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2019, Cancer Treatment ReviewsCitation Excerpt :Finally, 141 articles describing 273 patients were selected for systematic review [2,4,5,7,8,13,15–149] (Fig. 2). Out of 273 poorly differentiated NECs of the larynx reported between 1972 and 2019, 230 cases were of SCNEC histology (84.2%, reported in 128 publications: [2,5,7,8,15–63,65–90,92,94–103,105–112,114,116–118,120–139,141,143,145–147,149]) and 43 cases were LCNECs (15.8%, reported in 20 publications: [4,13,64,82,91,93,104,113,115,118,119,124,125,137,138,140,142,144,146,148]). The number of relevant publications and the number of described SCNEC cases varied somewhat through the studied period.
‘Primary small cell carcinoma of tonsil: An extreme rarity.’
2019, Annals of Medicine and SurgeryPrimary small cell carcinoma with neuroendocrine properties of the mandible: A case report and literature review
2017, Journal of Dental Sciences
Conflict of interest: none.