ABSTRACT
Objective: To investigate the clinicopathological features, treatment and prognosis of maxillofacial neuroendocrine carcinoma. Methods: A total of 11 patients with maxillofacial neuroendocrine carcinoma diagnosed in the Department of Pathology of The First Affiliated Hospital of Zhengzhou University from December 2010 to July 2022 were retrospectively enrolled, including 8 males and 3 females, aged (65.2±9.5) years (ranged from 49 to 87 years), with a disease course of 0.5 to 6.0 months. The clinicopathological data including head and neck CT, MRI and treatment methods were analyzed. Results: Submandibular gland and maxilla were involved in 3 cases, parapharynx in 2 cases, and face, tongue root and soft palate in 1 case respectively. Clinically, the initial symptom is a rapidly growing painless or tender mass, which may be accompanied by restricted mouth opening, dysphagia, and local numbness after invasion of masticatory muscles and nerves. The tumors were all invasive and low-density, with unclear boundaries from the surrounding tissues. Among the patients, 9 received surgical treatment, and 5 received adjuvant treatment after surgery (2 received chemotherapy, 3 received radiotherapy+chemotherapy). According to the 5th edition of the World Health Organization classification of head and neck tumors in 2022, there were 1 case (1/11) with poorly differentiated large cells and 10 cases (10/11) with poorly differentiated small cells. Histologically, the macrocell type is composed of large cells with rough chromatin, obvious vacuolar nucleolus, protruding nucleolus, and necrosis. The small cell type is dominated by small blue round cells with neuroendocrine characteristics, with active growth and multifocal necrosis. Immunohistochemical staining showed that cytokeratin (CK), epithelial membrane antigen (EMA) and synaptophysin (Syn) were diffusively expressed, 10 cases expressed CD56, 8 cases expressed p63, 6 cases expressed weakly punctated chromograin-A (CgA), and S-100 was not expressed. The Ki-67 index ranges from 20 to 90 percent. By the end of follow-up (0.5 to 127.0 months), 3 patients were alive, and the mean progression-free survival (21.0 months) of postoperative chemoradiotherapy patients was significantly longer than that of surgery and/or chemotherapy alone (3.3 months). Conclusions: Maxillofacial neuroendocrine carcinoma is characterized by low differentiation of small cells, high degree of malignancy and poor prognosis. Radical surgery combined with chemoradiotherapy has better local control effect.
Subject(s)
Male , Female , Humans , Carcinoma, Small Cell/therapy , Retrospective Studies , Carcinoma, Neuroendocrine/pathology , Prognosis , TongueABSTRACT
Small cell neuroendocrine carcinoma rarely appears primarily in the head and neck and exhibits aggressive behavior with a poor prognosis. The pathologist has a significant role in the diagnosis, and a consensual treatment still does not exist. The authors report the case of a middle-aged male patient who presented repeated episodes of massive epistaxis. The diagnostic work-up disclosed the diagnosis of small cell neuroendocrine carcinoma of the nasopharynx. The patient was treated with chemotherapy followed by radiotherapy. Imaging examinations performed after the end of treatment showed apparent complete remission of the disease. The patient was kept under active surveillance with no signs of local relapse or distant metastasis after 4 years of follow-up.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Neuroendocrine/therapy , Carcinoma, Small Cell/therapy , Nasopharynx/pathology , Carcinoma, Neuroendocrine/drug therapy , Carcinoma, Neuroendocrine/radiotherapy , Epistaxis/etiology , Remission InductionABSTRACT
Se reportaron los resultados de un estudio retrospectivo de pacientes con carcinoma de células pequeñas de pulmón en todos los estadios de la enfermedad, diagnosticado por citología y/o biopsia de la lesión. Métodos: Se estudiaron 68 enfermos que padecían un carcinoma de células pequeñas de pulmón en todos los estadios y recibieron tratamiento de primera línea con cisplatino-etopósido y de segunda línea, con ciclofosfamida, doxorubicina y vincristina. Los pacientes de enfermedad limitada fueron evaluados al final del primer ciclo para planificar el tratamiento con radiaciones; los de enfermedad extendida recibieron radiaciones sobre sitios metastásicos o para mejorar algún síntoma. Resultados: La respuesta al tratamiento fue: 25 por ciento de respuesta objetiva (RC y RP) y 56 por ciento de control de la enfermedad. La mediana de supervivencia global fue 10,10 meses. En el sexo femenino se observó tendencia a un incremento de la supervivencia en relación con el masculino (10,23 vs. 9,33 meses). La supervivencia en la enfermedad limitada fue de 12,5 meses y en la enfermedad extendida, de 6,57 meses lo cual fue estadísticamente significativo (p = 0,004).
The results of a retrospective study of patients with small cell lung carcinoma in all the stages of the disease diagnosed by cytology and/or biopsy of the lesion were reported. Methods: 68 patients that suffered from a small cell lung carcinoma in all the stages that received first-line treatment with cisplatin-etoposide, and second line treatment with cyclophosphamide, doxorubicin and vincristine were studied. The patients with limited disease were evaluated at the end of the first cycle to plan the treatment with radiations; those with extended disease received radiations on metastic sites or to improve some symptom. Results: The response to the treatment was as follows: 25 percent of objective response (CR and PR) and 56 percent of control of the disease. The global mean survival was 10.10 months. Among females, it was observed a trend towards an increase of survival compared with males (10.23 vs. 9.33 months). The survival of the limited disease was 12.5 months, whereas in the extended disease it was 6.57 months, which was statistically significant (p = 0,004).
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged, 80 and over , Carcinoma, Small Cell/therapy , Lung Neoplasms/therapy , Survival Analysis , Retrospective StudiesABSTRACT
The oat-cell carcinoma is more frequently found in the lungs, but has been described in other organs. It is a rare but aggressive tumor and its prognosis is dismal. The longest survival time reported is 22 months. In our patient was 15 months. We treated at the National Cancer Institute of Panama a 52-year-old patient with oat-cell carcinoma of the esophagus and described his symptoms, pathology, treatment and results
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Small Cell/diagnosis , Esophageal Neoplasms/diagnosis , Carcinoma, Small Cell/complications , Carcinoma, Small Cell/therapy , Emergencies , Fatal Outcome , Remission Induction , Esophageal Neoplasms/complications , Esophageal Neoplasms/therapy , Combined Modality Therapy , Deglutition Disorders/diagnosis , Deglutition Disorders/etiologyABSTRACT
Se trataron 57 pacientes portadores de carcinoma de pulmón de células pequeñas: 26 con quimioterapía y 31 con terapías de sostén clínico. En el primer grupo hubo 19,2 por ciento de respuestas objetivas con 80,8 por ciento de mortalidad. Entre los tratados con sostén clínico falleció el 96,7 por ciento. La sobrevida media fue de 8,1 mes y 5,0 meses respectivamente