• Archives of Craniofacial Surgery
• /
• v.19 no.3
• /
• pp.205-209
• /
• 2018

Merkel cell carcinoma (MCC) is an uncommon neuroendocrine cutaneous tumor with poor prognosis. It has the high rate of recurrence, mortality, regional nodal involvement, and distant metastases. It is difficult to diagnose MCC because of its non-specific clinical findings. It usually occurs on sun-exposed areas of the skin, mostly at head and neck. There is a difference in the incidence and prognosis according to site in the head and neck. However, there is no consented site-specific diagnosis, treatment or follow-up protocol for MCC at the head and neck. We herein report a case of MCC arising in the right earlobe of an otherwise healthy young man who has been diagnosed early, thereby successfully treated. With our closed follow-up, there was no tumor recurrence or complication at 33 months after diagnosis.

• Journal of Gastric Cancer
• /
• v.16 no.4
• /
• pp.266-270
• /
• 2016

We report a unique case of synchronous double primary gastric cancer consisting of adenocarcinoma components with micropapillary features and composite glandular-endocrine cell carcinoma components. The patient was a 53-year-old man presenting with a 6-month history of epigastric pain and diarrhea. A subtotal gastrectomy was performed. Histologically, one tumor was composed of micropapillary carcinoma components (50%) with tight clusters of micropapillary aggregates lying in the empty spaces, admixed with moderately differentiated adenocarcinoma components. MUC-1 was expressed at the stromal edge of the micropapillary component. The other tumor was composed of atypical carcinoid-like neuroendocrine carcinoma (50%), adenocarcinoid (30%), and adenocarcinoma components (20%). The neuroendocrine components were positive for CD56, synaptophysin, chromogranin, and creatine kinase. The adenocarcinoid components were positive for both carcinoembryonic antigen and neuroendocrine markers (amphicrine differentiation). This case is unique, due to the peculiar histologic micropapillary pattern and the histologic spectrum of adenocarcinoma adenocarcinoid-neuroendocrine carcinoma of the synchronous composite tumor.

• The Korean Journal of Cytopathology
• /
• v.16 no.2
• /
• pp.93-97
• /
• 2005

Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine carcinoma which commonly presents as a skin nodule, and can develop into regional lymph node metastases, as well as spread systematically. Here, we describe the cytological features of a touch imprint of MCC that arose on the face of a 62-year-old female. This touch imprint was acquired from an incisional biopsy specimen which had been submitted for frozen section. The touch preparation produced a highly cellular imprint of loosely cohesive groups of small- to medium-sized malignant cells exhibiting uniform round to oval nuclei, delicate nuclear membranes, fine chromatin, small nucleoli, and scanty cytoplasm, with occasional paranuclear button-like inclusions. We applied cytokeratin 20 to the touch imprint for immunochemistry, allowing us to visualize the tumor cells with paranuclear dot-like positivity. Both the cytological and immunocytological features were quite distinct.

• Korean Journal of Head & Neck Oncology
• /
• v.31 no.1
• /
• pp.22-26
• /
• 2015

Small cell carcinoma of larynx has been reported as a rare disease occurring in 0.5% of larynx cancer. This tumor is known as one of the most lethal of all malignancies and associated with early recurrence and distant metastasis, leading into death. We experienced a case of a 70-year old male patient, who had admitted for sore throat and dysphagia and diagnosed as small cell carcinoma of larynx. We present small cell carcinoma of larynx with a brief review of literature.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.2205-2210
• /
• 2014

Objective: To retrospectively review the clinical characteristics and analyze the prognostic factors of Chinese patients with pulmonary neuroendocrine tumors. Materials and Methods: The clinical data of 176 patients with pulmonary neuroendocrine tumors in Chinese PLA General Hospital from Mar., 2000 to Oct., 2012 were retrospectively analyzed. The parameters were evaluated by univariate and multivariate analysis, including the gender, age, smoking history, family history, TNM staging, localization (central or peripheral), tumor size, nodal status, histological subtype and treatment (operation or non-operation). Results: There were 23 patients with typical carcinoids (TC) (13.1%), 41 with atypical carcinoids (AC) (23.3%), 10 with large cell neuroendocrine carcinoma (LCNEC) (5.7%) and 102 with small cell lung cancer (SCLC) (57.9%). The median follow-up time was 64.5 months for AC, 38 months for LCNEC and 27 months for SCLC. The typical carcinoid censored data was 18 (more than 50% of the patients), so the median follow-up time was not obtained, and actuarial 5-year survivals for TC, AC, LCNEC and SCLC were 75.1%, 51.7%, 26.7% and 38.8%, respectively. COX univariate analysis revealed that the age (P=0.001), histological subtype (P=0.005), nodal status (P=0.000), treatment (P=0.000) and TNM staging (P=0.000) were the prognostic factors of the patients with pulmonary neuroendocrine tumors, whereas its multivariate analysis showed that only the age(P=0.001), TNM staging (P=0.002) and treatment (P=0.000) were independent prognostic factors. Conclusions: Radical surgery remains the treatment of choice, and is the only curative option. The age, TNM staging and treatment are confirmed to be the independent prognostic factors in multivariable models for pulmonary neuroendocrine tumors.

• Journal of Chest Surgery
• /
• v.29 no.8
• /
• pp.923-926
• /
• 1996

Small cell carcinoma of esophagus is a rare malignant tumor Recently we experienced one case of small cell carcinoma in mid thoracic esophagus. The patient was a 68 year old male patient. On preoperative endoscopic biopsy, neuroendocrine carcinoma was suspected. Esophagectomy and esophagogastrostomy was performed. Postoperative course was uneventful and patient was discharged without specific complicalion.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.16 no.1
• /
• pp.76-80
• /
• 2005

Although primary neuroendocrine carcinomas(NEC) are uncommon tumors of the larynx, they represent the most common nonepidermoid malignancy of this organ. Whereas typical carcinoid tumors and small-cell carcinomas occur very rarely in the larynx, the majority of laryngeal NEC belong to a broad intermediate group between these two extremes of NEC. Through many case studies, a major protion of clinicopathologic characteristics of laryngeal NEC have been revealed; however, the gistogenesis of laryngeal NEC is still unknown. The only well-documented normal neuroendocrine structures of the larynx are paraganglions, but the incidence of laryngeal paragangliomas are much lower than that of NEC. Here, we report on three cases of NEC affecting the larynx and the results of searching for neuroendocriene cells in non-neoplastic larynx tissue.

• The Korean Journal of Gastroenterology
• /
• v.72 no.6
• /
• pp.318-321
• /
• 2018

Primary neuroendocrine tumors originating from the extrahepatic bile duct are rare. Among these tumors, large cell neuroendocrine carcinomas (NECs) are extremely rare. A 59-year-old man was admitted to Sanggye Paik Hospital with jaundice that started 10 days previously. He had a history of laparoscopic cholecystectomy, which he had undergone 12 years previously due to chronic calculous cholecystitis. Laboratory data showed abnormally elevated levels of total bilirubin 15.3 mg/dL (normal 0.2-1.2 mg/dL), AST 200 IU (normal 0-40 IU), ALT 390 IU (normal 0-40 IU), and gamma-glutamyl transferase 1,288 U/L (normal 0-60 U/L). Serum CEA was normal, but CA 19-9 was elevated 5,863 U/mL (normal 0-37 U/mL). Abdominal CT revealed a 4.5 cm sized mass involving the common bile duct and liver hilum and dilatation of both intrahepatic ducts. Percutaneous transhepatic drainage in the left hepatic duct was performed for preoperative biliary drainage. The patient underwent radical common bile duct and Roux-en-Y hepaticojejunostomy for histopathological diagnosis and surgical excision. On histopathological examination, the tumor exhibited large cell NEC (mitotic index >20/10 high-power field, Ki-67 index >20%, CD56 [+], synaptophysin [+], chromogranin [+]). Adjuvant concurrent chemotherapy and radiotherapy were started because the tumor had invaded the proximal resection margin. No recurrence was detected at 10 months by follow-up CT.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.101-107
• /
• 2022

Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.

• Radiation Oncology Journal
• /
• v.36 no.2
• /
• pp.163-170
• /
• 2018

Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin initially believed to arise from the Merkel cells. In the community setting a general radiation oncologist may only encounter this pathology in a handful of cases over the course of their career. Due to the low incidence of this malignancy, few prospective randomized controlled trials have ever been conducted and therefore guidelines are based on relatively lower levels of evidence upon which the clinical recommendations are made. We discuss the case of a female in her 90s presenting with a classic MCC primary lesion, as well as satellite lesions proximal to both the primary and the draining regional lymph nodes with no evidence of nodal involvement. Here we discuss the presentation, management, treatment planning, underlying pathology, results and sequelae of treatment. We also review new treatment modalities, and the most current staging systems and guidelines.