English

Abstract

Neuroendocrine carcinoma of the head and neck are rare aggressive tumors and pose a diagnostic challenge. Differentiation from nasopharyngeal malignancies is difficult due to similar morphological characteristics and small biopsy specimen. Distinguishing is important because of difference in natural history, prognosis and treatment among these neoplasms. We report a 60 year old man with small cell neuroendocrine carcinoma of nasal cavity. Histology reveals highly cellular tumor with small nuclei with stippled chromatin pattern and scanty cytoplasm. Immuno-histochemical stain showed positivity for chromogranin A and cytokeratin, confirmed our diagnosis. INTRODUCTION: Small cell neuroendocrine carcinoma is a rare malignancy of the head and neck. It represents 0.5-1% of epithelial cancers of head and neck region. The 2005 World Health Organisation classification of Head and Neck Tumors categorizes these neoplasms as typical carcinoid tumor, atypical carcinoid tumor, small cell carcinoma neuroendocrine type (SNEC) and neuroendocrine carcinoma otherwise specified. 1,2,3 Patients with neuroendocrine malignancies usually present with locally advanced disease. These neoplasms can not generally be distinguished based on clinical or radiological criteria and hence require histopathological evaluation and further immunohistochemical confirmation of neuroendocrine differentiation. It should be differentiated from other sinonasal tumors like esthesioneuroblastoma (ENB), sinonasal undifferentiated carcinoma (SNUC) and lymphomas.4,5