CASE REPORT   

Otorhinolaryngology 2023 March;73(1):29-31

DOI: 10.23736/S2724-6302.22.02469-0

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Mixed neuroendocrine-non neuroendocrine neoplasm presenting in the neck as an occult primary tumor

Andrea COSTANTINO ^{1, 2}, Bianca M. FESTA ^{1, 2} ✉, Barbara FIAMENGO ³, Giuseppe SPRIANO ^{1, 2}, Giuseppe MERCANTE ^{1, 2}, Armando DE VIRGILIO ^{1, 2}

¹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; ² Unit of Otorhinolaryngology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; ³ Unit of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

Mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN) are extremely rare in the head and neck region. We report a unique case of MiNEN presenting as cervical node metastases of an occult primary tumor. A 72-year-old man presented with multiple clinically palpable firm and enlarged lymph nodes in the right side of the neck. The patient underwent complete diagnostic workup of an occult primary tumor and a modified radical neck dissection type III. After surgery, the patient was staged as an occult primary tumor (pT0N3b cM0). Histologic evaluation demonstrated a mixed tumor consisting of a poorly differentiated squamous cell carcinoma and a second neuroendocrine component composed by a proliferation of closely packed, round to oval atypical cells. Pathologists and clinicians must be aware that MiNEN could present as an occult primary tumor metastatic to cervical lymph nodes. Elective larynx irradiation may be recommended after surgery.

KEY WORDS: Neuroendocrine tumors; Head and neck neoplasms; Neoplasms, unknown primary