喉神经内分泌癌临床分析

目的　探讨喉神经内分泌癌的诊断、治疗及预后情况。方法　回顾性分析重庆医科大学附属第一医院耳鼻咽喉科2006年～2012年收治的6例喉神经内分泌癌患者 的临床资料。结果　随访时间3～54个月。1例典型类癌就诊时发现颈椎转移,未治疗随访13个月后死亡;2例非典型类癌,1例手术联合放化疗治疗后23个月未见复发转移,另1例单纯放疗后34个月后出现局部复发,行手术挽救性治疗后20个月肺转移及骨转移;3例小细胞神经内分泌癌,1例行放化疗后10个月局部复发,手术挽救性治疗后5个月远处转移死亡,另2例行放化疗后4个月及17个月远处转移死亡。结论  喉神经内分泌癌很少见,预后差,极易复发转移,治疗方式 及预后情况与喉神经内分泌癌病理亚型密切相关。     

喉神经内分泌肿瘤临床特征

目的：探讨喉神经内分泌肿瘤的临床表现、诊断及治疗。方法：回顾分析我科收治的3例喉神经内分泌肿瘤，其中非典型类癌2例，行根治性手术切除及颈廓清术；嗜铬细胞瘤1例，行肿瘤局部切除术。结果：非典型类癌2例，术后随访1年，情况稳定。嗜铬细胞瘤1例，术后随访11年，预后良好。结论：喉神经内分泌肿瘤是一组形态各异的病变，正确诊断有赖于临床特点、光镜、免疫组织化学检查，部分患者需行超微结构检查。不同类型的肿瘤应行不同的治疗方法。     

喉神经内分泌癌

目的:探讨喉神经内分泌癌的诊断和治疗.方法:对10例喉神经内分泌癌的临床、病理、诊断、治疗和预后进行回顾性分析.结果: 8例非典型类癌主要行外科手术:1例单纯行水平半喉切除术者于术后22个月死亡;1例失访;其余6例均随访超过2年以上,未见复发.2例小细胞喉神经内分泌癌采用手术切除+放化疗的联合性治疗方案,1例经联合治疗仍于术后14个月死亡;1例术后正行放化疗中.结论:喉神经内分泌癌是一种较为罕见的恶性肿瘤,正确诊断有赖于临床特点、组织病理学、免疫组织化学检查.不同类型的喉神经内分泌癌应行不同的治疗方法,预后差异较大.     

喉神经内分泌肿瘤诊断和治疗进展

喉神经内分泌肿瘤可分为上皮源性和神经源性。后者由嗜铬细胞瘤组成 ,而上皮源性组由典型和非典型类癌和小细胞神经内分泌癌组成 ,后者包括燕麦细胞型、中间细胞型和混合细胞型。本文综合报道 50 0多例喉神经内分泌肿瘤的诊治情况     

010喉神经内分泌肿瘤诊断和治疗进展

喉神经内分泌肿瘤可分为上皮源性和神经源性。后者由嗜铬细胞瘤组成,而上皮源性组由典型和非典型类癌和小细胞神经内分泌癌组成,后者包括燕麦细胞型、中间细胞型和混合细胞型。本文综合报道500多例喉神经内分泌肿瘤的诊治情况。     

010喉神经内分泌肿瘤诊断和治疗进展

喉神经内分泌肿瘤可分为上皮源性和神经源性.后者由嗜铬细胞瘤组成,而上皮源性组由典型和非典型类癌和小细胞神经内分泌癌组成,后者包括燕麦细胞型、中间细胞型和混合细胞型.本文综合报道500多例喉神经内分泌肿瘤的诊治情况.     

鼻腔鼻窦神经内分泌癌8例并文献复习

目的 探讨鼻腔鼻窦神经内分泌癌的临床特征、病理表现、治疗手段、预后及影响预后的因素。 方法 回顾经病理证实的8例原发性鼻腔鼻窦神经内分泌癌患者的临床病例资料。 结果 随访5~70个月,中位随访时间23个月, 8例中典型类癌1例、不典型类癌4例、小细胞神经内分泌癌2例、复合型神经内分泌癌1例(低分化神经内分泌癌伴内翻性乳头状瘤);平均46岁(34~57岁);T2期2例,T4期6例;接受手术7例,接受放疗6例,接受化疗6例,以手术+术后放化疗为最常见的治疗方式。 结论 神经内分泌癌最终确诊依靠术后病理和免疫组化指标,主要影响生存率的不良预后因素包括病理亚型和相关的治疗方式的选择。典型类癌、不典型类癌首选手术治疗,对于低分化亚型的神经内分泌癌,综合治疗对肿瘤局部控制和延长生存期有帮助。     

蝶窦类癌1例并文献复习

神经内分泌癌（neuroendocrine carcinoma,NEC）为神经内分泌肿瘤分泌的激素暂时未能确定者。根据肿瘤细胞分化程度和肿瘤生物学行为,鼻神经内分泌癌可参照喉的同类肿瘤将其分为三种类型：高分化NEC（类癌）,中分化NEC（非典型类癌）和低分化NEC（小细胞和中等细胞NEC）。世界卫生组织关于上呼吸道及耳肿瘤术语（1991）推荐使用：典型类癌（高分化神经内分泌癌,类癌瘤）,     

鼻腔鼻窦神经内分泌癌11例诊疗分析

目的 探讨鼻腔鼻窦神经内分泌癌的诊疗方法及预后.方法 回顾性分析浙江省肿瘤医院1998-2010年收治的11例鼻腔鼻窦神经内分泌癌患者的临床资料.其中小细胞神经内分泌癌10例,非典型类癌1例.参照Kadish分期本组患者A期2例,B期6例,C期3例.治疗方法采取单纯手术1例,单纯放疗1例,单纯化疗1例,放疗+化疗2例,以手术为主的综合治疗(手术结合术后放化疗)6例.结果 全部患者随访2个月至12年,综合治疗的6例中1例3年后死亡,1例4年后死亡,1例无瘤生存12年,另2例无瘤生存8年,1例仍在治疗随访中.其他治疗方案的5例中4例1年内死亡,1例1年半后死亡.结论 本病治疗并无统一方案,以手术为主的综合性治疗是较合适的治疗方案.神经内分泌癌易复发,预后较差,早期的准确诊断和综合治疗是提高本病生存率的关键.     

喉神经内分泌癌九例临床病理分析

目的 总结喉神经内分泌癌患者的临床表现、治疗方法及预后.方法 回顾性分析2005年5月至2011年6月共收治9例喉神经内分泌癌患者的临床资料,男6例,女3例;年龄35～65岁,中位年龄58岁.结果 治疗方法采取单纯手术5例,手术加术后放化疗4例.2例喉典型类癌患者随访28、30个月未复发;3例喉不典型类癌患者,其中1例在随访至36个月时复发,再次手术后已随访30个月,未见局部复发及远处转移,另2例分别随访15、20个月,均未复发;3例喉小细胞神经内分泌癌患者,1例随访18个月仍存活,另2例分别于术后11及14个月死亡;喉副神经节瘤1例,随访32个月未复发.结论 喉神经内分泌癌诊断有赖于临床特点、组织病理学及免疫组化检查.本病并无统一治疗方案,不同病理亚型的治疗方法及预后不同,对恶性程度较高的亚型主张采取以手术为主的综合治疗方案.     

喉神经内分泌癌的研究进展

喉神经内分泌癌是一种罕见的起源于上皮型神经内分泌细胞的喉恶性肿瘤,根据分化程度和细胞类型分为4种组织学亚型:典型类癌、非典型类癌、小细胞神经内分泌癌和大细胞神经内分泌癌。不同肿瘤亚型差异很大,由于发病率过低致使这些差异的正确描述一直受到阻碍。因报道过少的病例或无法收集足够的样本量,文献中常常存在相互矛盾的结果,很难形成共同的认知。综述近期的文献资料,就喉神经内分泌癌的临床行为、特点、诊断、治疗及预后等方面进行文献复习,提高临床医生对该病的认识,优化诊治方案。     

Terminology and classification of neuroendocrine neoplasms of the larynx.

The authors discuss the terminology and classification of all neuroendocrine neoplasms of the larynx. After a review of the relevant literature, they suggest adopting the nomenclature recently recommended by the World Health Organization: carcinoid tumor, atypical carcinoid tumor, small cell neuroendocrine carcinoma and paraganglioma. This terminology is easy to apply, clinically meaningful and biologically sound. Carcinoid tumor, atypical carcinoid tumor and small cell neuroendocrine carcinoma are of epithelial origin whereas paraganglioma is of neural type. The authors emphasize that it is inadequate to make a diagnosis of 'neuroendocrine tumor or carcinoma', without its proper qualification.     

Typical carcinoid tumor of the nasal cavity

The nasal cavity is a rare site of origin of neuroendocrine tumors. They can be classified typical carcinoid, atypical carcinoid and small cell carcinoma, neuroendocrine type. The tumor histology and prognosis correlate closely. The typical carcinoid tumors are well differentiated with benign course. The treatment of the typical carcinoid is a conservative surgery and the prognosis is good. But, typical carcinoid tumor of the nasal cavity was extremely rare, so the treatment has not been established. We report a case of typical carcinoid tumor of the nasal cavity in a 76-year-old man who treated by conservative surgery using sinus endoscopy. To the best of our knowledge this is the first report on an typical carcinoid in the nasal cavity.     

Neuroendocrine neoplasms of the larynx

Neuroendocrine neoplasms of the larynx are a rare group of tumors that include carcinoid tumor, atypical carcinoid tumor, and small cell carcinoma. These neoplasms pose interesting diagnostic, prognostic, and therapeutic dilemmas, and they are, as a whole, aggressive tumors with a tendency for local and distant spread. The authors of this study examined six new cases of laryngeal neuroendocrine neoplasms. One case manifested itself as a primary atypical carcinoid tumor and caused a “carcinoid syndrome.” The remaining five cases were small cell carcinomas of the larynx. Histologic, immunocytochemical, DNA flow cytometric, and p⁵³ studies were performed on all cases. The expression of neuron-specific enolase and chromogranin were the most useful markers in this group of tumors. Overexpression of p⁵³ protein was present in the majority of cases, including the atypical carcinoid tumor. The implications of these studies for diagnosis, classification, and treatment are discussed.     

Laser excision of a typical carcinoid tumor of the larynx: a case report

Neuroendocrine carcinomas of the larynx include a range of rare tumors which have variable biologic behavior, affecting treatment and prognosis. Among these, typical carcinoid tumors are the least common type. Prognosis of typical carcinoid tumor is better than atypical carcinoid tumor and small cell carcinoma of the larynx. Conservation surgery is the preferred treatment modality. Transoral CO2 laser surgery can be a good alternative for appropriate cases because of the functional results and less morbidity. In this article, a 71-year-old female presented with complaints of feeling a mass during swallowing. Fiberoptic examination of the larynx revealed a mass located on the right aryepiglottic fold and biopsy revealed the tumor as a typical carcinoid tumor. We describe CO2 laser excision of a typical carcinoid tumor of the larynx in this case report.     

Typical carcinoid tumor of the larynx occurring with otalgia: a case report

Neuroendocrine neoplasms of the larynx comprise a rare group of tumors that have a controversial history with regard to their classification. The World Health Organization categorizes these tumors as typical carcinoids, atypical carcinoids, small-cell neuroendocrine carcinomas, and paragangliomas. Atypical carcinoids and small-cell neuroendocrine carcinomas are the more common. Only 13 cases of typical carcinoid have been reported. Local excision is sufficient for typical carcinoids and paragangliomas, but atypical carcinoids require neck dissection because of their tendency to metastasize. Small-cell neuroendocrine carcinomas are not cured by local excision, and these patients have the worst prognosis (5-year survival: 5%); their treatment is limited to chemo- and radiotherapy. Because of these variations in tumor behavior and treatment, it is essential that otolaryngologists and pathologists to be able to correctly identify the specific type of tumor in order to optimize patient treatment and survival. We report a case of typical carcinoid and review the pertinent literature on this subject.     

Primary carcinoid tumor of the frontal sinus: A case report

Carcinoid tumors are rare, indolent, neuroendocrine tumors that are most commonly found in the gastrointestinal tract and lungs. They occasionally develop in the head and neck, either as a primary tumor or, more commonly, as a metastasis. The most common sites of head and neck carcinoids are the larynx and middle ear. Only a few cases of carcinoid in the nasal cavity and paranasal sinuses have been reported. We describe a case of primary typical carcinoid of the frontal sinus in a 61-year-old man, and we review the clinical, imaging, surgical, and histochemical findings in this case. The patient was treated with endoscopic resection. A subsequent workup for metastatic and occult primary disease was negative, confirming that the frontal sinus was the primary source. At follow-up 12 months postoperatively, the patient remained without disease. To the best of our knowledge, this is the first report of a primary typical carcinoid tumor originating in the frontal sinus.     

Atypical carcinoid (moderately differentiated neuroendocrine carcinoma) of the uvula

Carcinoid (neuroendocrine) tumors of the head and neck rarely occur outside the larynx and, until now, none has been reported in the oral cavity. We describe what we believe is the first reported case of an atypical carcinoid tumor, or any other type of neuroendocrine carcinoma, of the uvula.     

Neuroendocrine tumors of larynx.

Neuroendocrine neoplasms of the larynx have either an epithelial or a neural basis. The former are more numerous and are classified as typical or atypical carcinoids and small cell neuroendocrine carcinomas. Paraganglioma is the sole type of neural neuroendocrine neoplasm. There is a significant worsening of prognosis from typical carcinoid to small cell neuroendocrine carcinoma, with the latter having a dismal 5-year survival rate regardless of therapy. Paragangliomas are the most benign of laryngeal neuroendocrine neoplasms, but their clinical behavior may not be predictable on the basis of their histologic appearance.