Oat cell carcinoma is a well known pulmonary entity. Reports of this disease at extrapulmonary sites, particularly the larynx, have been rare. The natural history of such a tumor in a 64‐year‐old man is documented in this report. This supraglottic tumor (classified as T2N1bM0 was surgically resectable. Because of the large cervical node, preoperative irradiation was performed. After completion of 4000 rads to the primary tumor and regional lymphatics, there was dramatic regression of disease at both sites. Subsequently, the patient underwent supraglottic laryngectomy and neck dissection. The gross specimen revealed microscopic residual tumor at the primary site (with uninvolved margins) and in the palpable cervical node. In spite of adequate surgical excision, the patient was dead of widespread distant metastases within two months of surgery. Review of the literature reveals that oat cell carcinoma at extrapulmonary sites is likely to behave in this manner. The operating laryngologist should be aware of this rare pathological variant because of its propensity for distant metastases in the presence of surgically curable disease in the region of origin. Alternative methods of management (including radiation therapy and chemotherapy) are discussed.
Conclusion: Distant failure still remains the overwhelming challenge for patients with UPSC. Our observations suggest that better local regional control with no detriment in DM, DFS, and OS is achieved using CCRT compared to SCRT schedule. CCRT addresses both local/regional and systemic disease upfront. Delaying RT until completion of systemic therapy may compromise local/pelvic control. Further, study with larger number of pts and longer follow-up is needed to define the optimal sequencing of combined modality therapy in UPSC.
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