Poorly differentiated laryngeal neuroendocrine neoplasm with high serum calcitonin level, a case report, with literature review

Abstract

Abstract Neuroendocrine neoplasm (NEN) of the larynx consists of 0.6% of laryngeal cancer and is the second most common type after squamous cell carcinoma (SCC). Laryngeal NEN rarely secret calcitonin and should be differentiated from medullary thyroid carcinoma. It makes a diagnostic and therapeutic challenge. We describe a case of a laryngeal NEN with calcitonin hypersecretion. A 59‐year‐old man presented to our clinic with recurrent cough, dysphonia, hoarseness, cervical mass, and significant weight loss. Diagnostic workup showed a supraglottic mass. Biopsy of the lesion revealed large‐cell neuroendocrine neoplasm. Further diagnostic workup showed elevated serum calcitonin level. The patient underwent total laryngectomy, thyroidectomy, and modified radical neck dissection. During his follow‐up, new subcutaneous nodules appeared that were biopsy‐proven metastases. Then adjuvant chemoradiotherapy was performed. Laryngeal NEN with hypersecretion of calcitonin is a rare entity. In patients with elevated serum calcitonin levels and head and neck tumors, it should be considered a differential diagnosis of medullary thyroid carcinoma. As the management and prognosis of these two neoplasms are entirely different.

Keywords

• calcitonin
• larynx
• neuroendocrine tumor
• primary.