Zusammenfassung
Kasuistik: Ausgehend von einem Patienten mit einem atypischen Karzinoid wird eine umfassende
Literaturrecherche durchgeführt. Hintergrund: Es wird insbesondere auf die Terminologie, histologische Differenzierung, Diagnostik
und Therapie neuroendokriner Tumoren eingegangen. Schlussfolgerungen: Die Lokalisation dieser Tumoren im Larynx ist untypisch und relativ selten. Dennoch
sollte sie wegen der möglichen malignen bis hochmalignen Verläufe der verschiedenen
Subtypen als Differenzialdiagnose geläufig sein. Da sich die laryngeale Manifestation
dieses neuroendokrinen Tumors (NET) klinisch different von entsprechenden Tumoren
gastrointestinaler oder pulmonaler Lokalisation verhält, lassen sich Therapieschemata
nicht ohne weiteres übertragen. Um so wichtiger erscheint es, diese Tumoridentität
wissenschaftlich genauer zu untersuchen. Schwierigkeiten ergeben sich dabei aus den
insgesamt sehr geringen Patientenzahlen, weshalb es das Anliegen dieser Arbeit ist,
das bisherige Wissen zusammenzufassen und auf die Wichtigkeit der Publikation von
Neuerkrankungen hinzuweisen.
Neuroendocrine Tumor of the Larynx (NETL) - An Uncommon Differential Diagnosis
Casuistry: The case of a patient with atypical carcinoid of the larynx is reported and literature
about neuroendocrine tumors of the larynx (NETL) is reviewed. Background: Especially terminology, histological differentiation, diagnostics and therapy are
discussed. Conclusions: Neuroendocrine tumors are rare and untypically located in the larynx. In spite of
this they should to be known as an important differential diagnosis of a laryngeal
neoplasia, because of possible malign or highly malign course. The typical localisation
of neuroendocrine tumors (NET) are the gastrointestinal tract and the lung, but the
clinical course differs from the one of laryngeal manifestation. This means diagnostics
and therapy have to be adapted to this special disease. That's why it is important
to explore the identity of these tumors scientifically. This is difficult because
of the low rate of patients with this disease. The message of this report is the conclusion
of the established and appeal for publications of new cases of NETL.
Schlüsselwörter:
Karzinoid - Larynx - Neuroendokrin - Paragangliom - Tumor
Key words:
Carcinoid - Larynx - Neuroendocrine - Paraganglioma - Tumor
Literatur
- 1
Kleinsasser O.
Revision of classification of laryngeal cancer, is it long overdue? (Proposals for
an improved TN-classification.)
J Laryngol Otol.
1992;
106
197-204
- 2
Kleinsasser O.
Sarcomalike patterns in laryngeal carcinoma (pseudosarcoma, carcinosarcoma, spindle-cell-carcinoma,
pleomorphic carcinoma [author's transl]).
Laryngo-Rhino-Otol.
1978;
57
225-234
- 3 Meyer-Breitling E, Burkhardt A. Tumours of the larynx. 1. Aufl. Springer-Verlag
1988 80: 153
- 04
Batsakis J G, Luna M A, el-Naggar A K.
Nonsquamous carcinomas of the larynx.
Ann Otol Rhinol Laryngol.
1992;
101
1024-1026
- 05
Lam K Y, Yuen A P.
Cancer of the larynx in Hong Kong: a clinico-pathological study.
Eur J Surg Oncol.
1996;
22
166-170
- 06 Herold G. Innere Medizin. Köln; 1996: 305-309
- 07 Riede U N, Schaefer H E.
Diffuses neuroendokrines System. Allgemeine und Spezielle Pathologie. 4. Aufl. Thieme-Verlag 1995: 1011-1014
- 08 Travis N D, Linnoila R I, Tsokos M G . et al .Neuroendocrine tumors of the lung
with proposed criteria for large cell neuroendocrine carcinoma. An ultrastructural,
immunohistochemical and flowcytometric study of 35 cases. Amer J Surg Pathol 1991
- 09
Gould V E, Lee I, Warren W H.
Immunohistochemical Evaluation of Neuroendocrine Cells and Neoplasms of the Lung.
Path Res Pract.
1988;
183
200-213
- 10
Delcore R, Friesen S R.
Gastrointestinal neuroendocrine tumors.
J Amer Surg.
1994;
178
187-211
- 11
Modlin I M, Sandor A.
An analysis of 8305 cases of carcinoid tumors.
Cancer.
1997;
79
813-829
- 12
Öberg K.
Biology, diagnosis and treatment of neuroendocrine tumors of the gastrointestinal
tract.
Curr Opin Oncol.
1994;
4
441-451
- 13
Perry R, Vinik A.
Endocrine tumors of the gastrointestinal tract.
Ann Rev Med.
1996;
47
57-68
- 14
Moisa I I, Silver C E.
Treatment of neuroendocrine neoplasms of the larynx.
J Oto-Rhino-Laryngol.
1991;
53
259-264
- 15
Ferlito A . et al .
A review of neuroendocrine neoplasms of the larynx: update on diagnosis and treatment.
J Laryngol Otol.
1998;
112
827-834
- 16
Ferlito A, Barnes L, Wenig B M.
Identification, classification, treatment, and prognosis of laryngeal paraganglioma.
Review of the literature and eight new cases.
Ann Otol-Rhinol-Laryngol.
1994;
103
525-536
- 17
Ferlito A, Friedmann I.
Contribution of immunhistochemistry in the diagnosis of neuroendocrine neoplasms of
the larynx.
J Oto-Rhino-Laryngol.
1991;
53
235-244
- 18
Ferlito A, Rosai J.
Terminology and classification of neuroendocrine neoplasms of the larynx.
J Oto-Rhino-Laryngol.
1991;
53
185-187
- 19
Barnes L.
Paraganglioma of the larynx. A critical review of the literature.
J Oto-Rhino-Laryngol.
1991;
53
220-234
- 20
Gnepp D R.
Small cell neuroendocrine carcinoma of the larynx. A critical review of the literature.
J Oto-Rhino-Laryngol.
1991;
53
210-219
- 21
Woodruff J M, Senie R T.
Atypical carcinoid tumor of the larynx. A critical review of the literature.
J Oto-Rhino-Laryngol.
1991;
53
194-209
- 22
Martinez-Madrigal F, Bosq J, Micheau C, Nivet P, Luboinski B.
Paragangliomas of the head and neck. Immunohistochemical analysis of 16 cases in comparison
with neuroendocrine carcinomas.
Pathol Res Pract.
1991;
187
814-823
- 23
Salim S A, Milroy C, Rode J, Corrin B, Hamid Q.
Immunocytochemical characterization of neuroendocrine tumours of the larynx.
Histopathology.
1993;
23
69-73
- 24
Blok P H, Manni J J, van den Broek P, van Haelst U J, Slooff J L.
Carcinoid of the larynx: a report of three cases and a review of the literature.
Laryngoscope.
1985;
95
715-719
- 25
Woodruff J M, Huvos A G, Erlandson R A, Shah J P, Gerold F P.
Neuroendocrine carcinomas of the larynx. A study of two types, one of which mimics
thyroid medullary carcinoma.
Amer J Surg Pathol.
1985;
9
771-790
- 26
Dieler R, Dammrich J.
Immunohistochemical and fine structural characterization of primary carcinoid tumors
of the larynx.
Europ Arch Otorhinolaryngol.
1995;
252
229-235
- 27
Dellagi K, Jaubert F, Micheau C, Brasnu D, Laccoureye H.
Carcinoid of the larynx. Well-differentiated neuroendocrine carcinoma. Apropos of
4 cases.
Ann Pathol.
1989;
9
284-288
- 28
Ereno C, Lopez J I, Sanchez J M.
Atypical carcinoid of larynx: presentation with scalp metastases.
J Laryngol Otol.
1997;
111
89-91
- 29
Batsakis J G, el-Naggar A K, Luna M A.
Neuroendocrine tumors of larynx.
Ann Otol-Rhinol-Laryngol.
1992;
101
710-714
- 30
Kau R, Arnold W.
Somatostatin receptor scintigraphy and therapy of neuroendocrine (APUD) tumors of
the head and neck.
Acta Otolaryngol.
1996;
116
345
- 31
Moertel C G.
Treatment of the carcinoid tumor and the malignant carcinoid syndrome.
J Clin Oncol.
1983;
1
727-740
- 32
Moertel C G, Rubin J, Kvols L K.
Therapy of metastatic carcinoid tumor and the malignant carcinoid syndrome with recombinant
leukocyte A interferon.
J Clin Oncol.
1989;
7
865-868
Dr. med. Michael Hoff
HNO-Universitätsklinik Otto Körner
Doberaner Straße 137 - 139 18057 Rostock
