Carcinoids in the head and neck region

Background:

Carcinoids are very rare and constitute a subgroup of neuroendocrine tumors. Only 54 cases of middle ear carcinoids have been published in the literature (Murphy et al.). In 1% of cases neuroendocrine neoplasias also occur in the larynx. This work is intended to present a rare clinical disease and therapeutic decisions made.

Patients and Methods:

We report on 2 patients with neuroendocrine neoplasia in the head and neck area. A 37-year-old male patient presented to our department with a history of recurrent cholesteatoma on the right side. He reported recurrent otorrhoea and hearing loss on the right side. Audiometry showed a combined hearing. During tympanoplasty type IIIa on the right side, a signal polyp in the tympanic cavity and a cholesteatoma were visible.

A 60-year-old male patient presented with dyspnoea and dysphagia. Panendoscopy showed a 2 cm large exophytic tumor of the right aryepiglottic fold. We performed endolaryngeal tumor resection with modified radical neck dissection on both sides.

Results:

Histologically and immunohistochemically a neuroendocrine tumor of the subtype “Typical Carcinoid” was found in both tissue excisions. Postoperative staging examination showed no lymph node or distant metastasis in both cases. pT1 stadium was found for both tumors. Postoperative regular tumor follow-up is currently continued in both patients.

Conclusion:

There is still no current guideline for this tumor entity. Therapy of choice, however, is surgical removal of both primary and metastatic carcinoids. With small, locally confined carcinoids and a clinical N0 status, tumor resection and regular clinical follow-up apparently yields a disease free result.

Publication History

Publication Date:
23 April 2019 (online)