Mucosal large cell neuroendocrine carcinoma of the head and neck regions in Japanese patients: a distinct clinicopathological entity.
BACKGROUND
Large cell neuroendocrine carcinoma (LCNEC) is well-known as a lung cancer subtype. This study assessed the prevalence of head and neck mucosal LCNEC (M-LCNEC).


METHODS
M-LCNEC was studied clinically, histologically and immunohistochemically.


RESULTS
Of 814 surgically resected cases of mucosal head and neck carcinoma, only eight cases (0.98%; all men, mean age 64.6 years) were rediagnosed as M-LCNEC. They occurred in the oropharynx (n=3), larynx (n=4) and hypopharynx (n=1). Seven of the cases had regional lymph node metastases and four resulted in death. Histologically, M-LCNEC had a sheet-like trabacular organoid growth pattern of relatively large basaloid cells in which central necrosis, rosette formation, peripheral palisading and high mitotic figures were evident. M-LCNEC was immunopositive for two or three neuroendocrine markers (CD56, chromogranin-A and synaptophysin). All cases showed high proliferative activity.


CONCLUSIONS
M-LCNEC in the head and neck regions is a distinct histopathological entity whose positivity for neuroendocrine markers makes its diagnosis important. As about half of the patients died of the disease, M-LCNEC has a relatively poor prognosis.
Pathology Division, Shizuoka Cancer Center Hospital and Research Institute, Shizuoka, Japan. k.kusafuka@scchr.jp
Kimihide
K
Kusafuka
Masato
M
Abe
Yoshiyuki
Y
Iida
Tetsuro
T
Onitsuka
Tomohito
T
Fuke
Rei
R
Asano
Tomoyuki
T
Kamijo
Takashi
T
Nakajima
D000368:Aged; D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D018287:Carcinoma, Large Cell / Q000737:chemistry / Q000208:ethnology / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry / Q000208:ethnology / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D053379:Chromogranin A / Q000032:analysis; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000208:ethnology / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000737:chemistry / Q000208:ethnology / Q000473:pathology; D007150:Immunohistochemistry; D007564:Japan / Q000453:epidemiology; D007822:Laryngeal Neoplasms / Q000737:chemistry / Q000208:ethnology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D009959:Oropharyngeal Neoplasms / Q000737:chemistry / Q000208:ethnology / Q000473:pathology; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D016708:Synaptophysin; D016896:Treatment Outcome; D033921:Vesicular Transport Proteins / Q000032:analysis
D014408:Biomarkers, Tumor; D019002:CD56 Antigen; C506150:CHGA protein, human; D053379:Chromogranin A; C522918:NCAM1 protein, human; C569014:SYP protein, human; D016708:Synaptophysin; D033921:Vesicular Transport Proteins