Metastasizing neuroendocrine carcinoma of the larynx with calcitonin and somatostatin secretion and CEA production, resembling medullary thyroid carcinoma

Smets, G.; Warson, F.; Dehou, Marie‐Françoise; Storme, Guy; Sacré, Robert; Belle, Simon Van; Somers, Guido; Gepts, W; Klöppel, Günter

doi:10.1007/bf01600306

Cited by 43 publications

(27 citation statements)

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“…However, there are rare exceptions as three out of over 300 reported cases of moderately differentiated neuroendocrine carcinoma of the larynx in the literature were reportedly associated with an elevated level of calcitonin. [19][20][21] In each of these three cases, thyroidectomies were performed and the evaluated tissue was reportedly negative for medullary carcinoma. Despite the recognition that only very rare cases of moderately differentiated neuroendocrine carcinoma of the larynx may have elevated serum calcitonin levels, a marker at the light microscopic level would be helpful for objectively distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid.…”

Section: Ttf-mentioning

confidence: 99%

Thyroid transcription factor-1, but not p53, is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid

2004

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Moderately differentiated neuroendocrine carcinoma/atypical carcinoid tumor is the most common nonsquamous malignancy in the larynx; however, due to morphologic overlap and calcitonin immunoreactivity, it can be difficult to distinguish from thyroid medullary carcinoma. Currently, low serum calcitonin is the most reliable means for distinguishing primary laryngeal moderately differentiated neuroendocrine carcinoma from metastatic medullary carcinoma. Thyroid transcription factor-1 (TTF-1) is positive in at least 80% of medullary carcinomas, but has not been evaluated in laryngeal moderately differentiated neuroendocrine carcinomas. Additionally, it has been suggested that p53 is positive in laryngeal moderately differentiated neuroendocrine carcinomas and negative in other neuroendocrine tumors, but this has not been validated. The purpose of this study was to determine if the immunohistochemical markers TTF-1 and p53 could be used to discriminate between laryngeal moderately differentiated neuroendocrine carcinomas and thyroid medullary carcinomas. Eight laryngeal moderately differentiated neuroendocrine carcinomas and 10 thyroid medullary carcinomas were identified from the archival files of the BWH and MGH Pathology Departments. Hematoxylin and eosin slides were reviewed, and immunohistochemistry was performed using antibodies to calcitonin, TTF-1, and p53. Calcitonin immunohistochemistry demonstrated immunoreactivity in 100% of laryngeal moderately differentiated neuroendocrine carcinomas (N ¼ 8) and 100% of thyroid medullary carcinomas (N ¼ 10). There was weak, focal immunoreactivity with TTF-1 in one of eight (13%) laryngeal moderately differentiated neuroendocrine carcinomas, whereas nine of ten (90%) medullary carcinomas were positive for TTF-1, with strong diffuse staining in seven of these cases (78%). p53 was positive in three of six (50%) laryngeal moderately differentiated neuroendocrine carcinomas, and three of ten (30%) medullary carcinomas. Our data demonstrate that immunoreactivity for TTF-1, but not calcitonin or p53, may be helpful in distinguishing laryngeal moderately differentiated neuroendocrine carcinoma and thyroid medullary carcinoma. In particular, diffuse and/or strong TTF-1 immunoreactivity favors a diagnosis of primary thyroid medullary carcinoma over laryngeal moderately differentiated neuroendocrine carcinoma. Keywords: carcinoid; neuroendocrine; medullary; larynx; thyroid; TTF-1; p53; calcitonin Moderately differentiated neuroendocrine carcinoma (atypical carcinoid tumor) is the most common nonsquamous malignancy in the larynx, metastasizing to regional lymph nodes, skin, subcutaneous tissue or distant sites in approximately 20-40% of cases. 1,2 Moderately differentiated neuroendocrine carcinomas of the larynx and medullary carcinomas of the thyroid demonstrate morphological overlap, and can be microscopically indistinguishable, particularly when presenting as a metastasis. Currently,

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Section: Ttf-mentioning

confidence: 99%

Thyroid transcription factor-1, but not p53, is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid

2004

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“…The literature on NCL is fragmented over numerous case reports and series of small sample size, often with contradicting results, making it difficult to decide on an appropriate treatment strategy. Consequently, physicians facing these tumors often resort to treatment paradigms developed for better known neoplasms (eg, squamous cell carcinoma).…”

Section: Introductionmentioning

confidence: 99%

Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases

et al. 2014

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“…In the case of a functional paragan glioma described by Justrabo et al [48], fluorometric assay revealed high norepinephrine and epinephrine lev- 3 Authors refer to the same patient. Neuroendocrine neoplasms of the larynx may release various hormone and enzyme markers into the blood but high serum levels of calcitonin [6,28,48], somatostatin [28] and NSE [28] have rarely been recorded.…”

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Contribution of Immunohistochemistry in the Diagnosis of Neuroendocrine Neoplasms of the Larynx

Ferlito

Friedmann²

1991

ORL

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This chapter illustrates the use of mono- and polyclonal antibodies as diagnostic tools for neuroendocrine neoplasms of the larynx on the basis of data from the literature and the authors’ personal experience. It is suggested that a panel of antibodies should be adopted, rather than to rely on the specificity and sensitivity of a single marker. It is also emphasized that immunohistochemical methods should serve not as a substitute but as a useful adjuvant in evaluating the morphological criteria of these neoplasms.

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Metastasizing neuroendocrine carcinoma of the larynx with calcitonin and somatostatin secretion and CEA production, resembling medullary thyroid carcinoma

Cited by 43 publications

References 17 publications

Thyroid transcription factor-1, but not p53, is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid

Thyroid transcription factor-1, but not p53, is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid

Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases

Contribution of Immunohistochemistry in the Diagnosis of Neuroendocrine Neoplasms of the Larynx

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