International Journal For Multidisciplinary Research

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Clinical Presentation and Treatment Strategies for Laryngeal Neuroendocrine Carcinoma: Insights from a Rare Case

Author(s) Rahul Dhama, Winsome Kumar, Anu Agrawal, Navaudhayam Ranganathan, Akhilesh Mishra
Country India
Abstract Intriduction -Neuroendocrine neoplasms (NEN) of the larynx are very rare, accounting for <1% of all laryngeal carcinomas. Based on the 2022 IARCH/WHO classification, NENs are characterised as well-differentiated neuroendocrine tumours (NET), which can further be divided into grades 1-3 based on Ki-67 levels and mitotic count, or poorly differentiated neuroendocrine carcinomas (NEC) consisting of small cell carcinoma and large cell carcinoma. In this case report, we describe a rare presentation of NEC of the larynx encountered in a 54-year-old man and how diagnostic and therapeutic dilemmas unfolded.
Case description: A 6-month history of breathing and swallowing difficulties led to a tracheostomy due to stridor, in the emergency department. Imaging revealed a soft tissue mass involving the supraglottic larynx but no significant associated cervical lymphadenopathy. The biopsy from the growth was suggestive of poorly differentiated NEC as an AJCC stage cT3N0M0. However, there was local progression post-initial treatment with vincristine, doxorubicin and cyclophosphamide (VAC). The chemotherapy regimen was switched to carboplatin and etoposide. The patient received definitive radiation therapy and completed the planned dose of radiation.After 10 months of disease-free interval, there was local recurrence with lung nodules that prompted rechallenge with platinum and etoposide. The patient is doing well and remains clinically and radiologically stable to maintenance therapy with carboplatin & etoposide.
Conclusion: NENs of the larynx and especially NECs, are difficult to diagnose as they are rare and have varied molecular profiles. Its management frequently calls for multimodal approaches with chemotherapy and radiation therapy. Due to the developments in diagnostic and therapeutic modalities, our knowledge of NENs has been enhanced which contributed to better practice standards. Nevertheless, standardized treatment strategies remain to be determined by large cohort studies and comprehensive molecular profiling that can determine improved clinical outcomes.
Keywords Neuroendocrine Carcinoma larynx, NET, NEC, NEN
Field Biology > Medical / Physiology
Published In Volume 6, Issue 4, July-August 2024
Published On 2024-08-03
Cite This Clinical Presentation and Treatment Strategies for Laryngeal Neuroendocrine Carcinoma: Insights from a Rare Case - Rahul Dhama, Winsome Kumar, Anu Agrawal, Navaudhayam Ranganathan, Akhilesh Mishra - IJFMR Volume 6, Issue 4, July-August 2024. DOI 10.36948/ijfmr.2024.v06i04.25609
DOI https://doi.org/10.36948/ijfmr.2024.v06i04.25609
Short DOI https://doi.org/gt55zk
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