Clinical Case Reports

Biography

Biography: Hanadi A Fatani

Abstract

Context: Primary neuroendocrine (NET) tumors of the larynx are rare in occurrence. Majority of case reports of NET larynx are associated with medullary carcinoma thyroid. In this backdrop, we report a case of NET larynx associated with solitary papillary thyroid carcinoma. Case report: A 51 year old female presented with 2 months’ history of sore throat, change in voice, odynophagia and left ear pain. On clinical examination, a non tender, firm, right sided thyroid nodule along with non tender, right cervical lymph node was found. Fiber optic endoscopy showed irregularity in the tip of epiglottis. CT/ PET scan showed thickening of epiglottis with enhancement after intravenous contrast and a small right enhancing lymph node measuring 1.5 cm. Laser resection of the epiglottis was carried out and histopathology revealed it as moderately differentiated neuroendocrine carcinoma. A week later the patient underwent total thyroidectomy with bilateral neck dissection. Immunohistochemistry was performed on epiglottis and lymphnode section with appropriate positive and negative control which showed CKpan+, Syn+, Chr A+, CEA+, Calcitonin +, CD56-, CK7-, CK20- and P63-. Ki 67 was reactive in about 10% of the neoplastic cells. The histopathology of thyroid section revealed a micro papillary thyroid carcinoma that was calcitonin negative. Following thyroidectomy and neck dissection, the patient underwent octreotide scan which was negative and the serum calcitonin level was found to be high (12 pg/ml, ref<8). Currently the patient is under clinical surveillance with no evidence of recurrent disease. Conclusion: To the best of our knowledge, we report the first case of primary calcitonin secreting neuroendocrine carcinoma of the larynx metastasizing to neck lymph nodes and associated with a solitary papillary thyroid carcinoma