title: Large cell neuroendocrine carcinoma presenting with neck swelling in the submandibular gland: a case report.
abstract: BACKGROUND
  Large cell neuroendocrine carcinoma in the salivary glands is rare. We report a second case of large cell neuroendocrine carcinoma of the submandibular gland diagnosed at autopsy, and a review of the literature.
  
  
  METHODS
  A 68-year-old Japanese man was referred to our hospital for thorough investigation of swelling on the right side of his neck. Fine-needle aspiration cytology of the cervical mass suggested poorly differentiated metastatic carcinoma. The primary tumor could not be detected by several examinations. One month after admission, he died of cancer. An autopsy was performed, and it revealed a tumor of the right submandibular gland. The histopathological diagnosis was large cell neuroendocrine carcinoma of the submandibular gland.
  
  
  CONCLUSIONS
  To the best of our knowledge, only eight cases of large cell neuroendocrine carcinoma in the salivary glands, including our case, have been reported. This report indicates total biopsy and immunohistochemistry are necessary for diagnosing large cell neuroendocrine carcinoma properly.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. kawara1010@yahoo.co.jp.
authors.forename: Hideto
authors.initials: H
authors.lastname: Kawaratani
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Tsujimoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Fumi
authors.initials: F
authors.lastname: Kawanami
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Shirai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshiji
authors.forename: Kousaku
authors.initials: K
authors.lastname: Morita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukui