laryngeal neuroendocrine tumor

Laryngeal Neuroendocrine Tumors: An Overview

Laryngeal neuroendocrine tumors (NENs) are rare and heterogeneous neoplasms that arise from the larynx. These tumors are characterized by their neuroendocrine differentiation, which is distinct from neural forms such as paraganglioma.

Types of Laryngeal NENs

There are several types of laryngeal NENs, including:

• Well-differentiated neuroendocrine tumors (NETs): These tumors are typically grade 1, 2, or 3 and have a good prognosis.
• Neuroendocrine carcinomas (NECs): These tumors can be small cell or large cell types and have a poorer prognosis.
• Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs): These tumors have both neuroendocrine and non-neuroendocrine components.

Clinical Presentation

Patients with laryngeal NENs typically present with non-specific clinical symptoms related to obstructive mass lesions, such as hoarseness, dysphagia, and sore throat. Paraneoplastic syndromes, including carcinoid, Eaton-Lambert, ACTH, or Schwartz-Bartter syndromes, may also occur.

Demographics

Laryngeal NENs tend to occur in middle-aged male patients with a history of heavy tobacco smoking.

References

• [1] Laryngeal cancer accounts for approximately 2% and 5% of new malignancies worldwide every year.
• [3] Epithelial malignancies with neuroendocrine differentiation can occur in any organ of the body.
• [10] Laryngeal NENs are divided into three categories: well-differentiated neuroendocrine neoplasms, poorly differentiated neuroendocrine carcinomas, and mixed neuroendocrine-non-neuroendocrine neoplasm.

Note: The information provided is based on a review of the search results and may not be comprehensive or up-to-date.

Common Signs and Symptoms

Laryngeal neuroendocrine tumors (NETs) can cause a variety of symptoms, which may resemble those of other conditions. The following are some common signs and symptoms associated with laryngeal NETs:

• Voice changes: Hoarseness or a change in voice tone is often one of the earliest symptoms of laryngeal NETs [11].
• Sore throat: A persistent sore throat or cough that won't go away can be an indication of laryngeal NETs [13].
• Throat pain: Pain or discomfort in the throat area may also occur, especially if the tumor is large or has grown into surrounding tissues [12].

Other Possible Symptoms

In addition to voice changes and sore throat, other possible symptoms of laryngeal NETs include:

• Shortness of breath: Difficulty breathing or feeling short of breath can be a symptom of advanced laryngeal NETs [14].
• Coughing: A persistent cough that won't go away may also occur, especially if the tumor is affecting the airway [11].

Important Note

It's essential to seek medical attention immediately if you experience any of these symptoms for an extended period (more than 3 weeks) or if they worsen over time. Early detection and treatment can significantly improve outcomes for laryngeal NETs.

References:

[11] Laryngeal cancer is cancer of your larynx (voice box). Signs and symptoms include voice changes such as hoarseness and a sore throat or cough that won't go away. [12] Learn more about the signs and symptoms of larynx cancer at NewYork-Presbyterian. ... Neuroendocrine carcinoma occurs in the cells that make hormones; Stages of Laryngeal Cancer Stages. Laryngeal cancer is assigned a stage based on how large the tumor is, where it has grown and whether it has spread to nearby lymph nodes or distant parts of the ... [13] Early laryngeal cancer symptoms may resemble a common cold. However, if certain symptoms, such as throat pain, voice hoarseness, and a cough, persist longer than 3 weeks, a person needs to speak ... [14] Neuroendocrine tumors (NETs) can cause lots of different symptoms, from shortness of breath to headaches to belly cramps. Find out more about symptoms and types of NETs.

Diagnostic Tests for Laryngeal Neuroendocrine Tumors

Laryngeal neuroendocrine tumors (NETs) are rare and can be challenging to diagnose. However, various diagnostic tests can help identify these tumors.

• Imaging Studies: Imaging studies such as CT scans, MRI scans, and Gallium scans can help detect the tumor and determine its stage [1]. These scans can also help identify any metastasis or spread of the cancer.
• Biochemical Tests: Biochemical tests measure the levels of certain enzymes or proteins in the blood or urine. These tests can help confirm the diagnosis of a NET [4].
• Light Microscopy: Light microscopy is often used to diagnose laryngeal NETs. It involves examining tissue samples under a microscope to look for characteristic features of the tumor [2, 8].
• Immunohistochemistry and Electron Microscopy: Immunohistochemistry and electron microscopy can be used to confirm the diagnosis of a NET. These tests involve staining tissue samples with specific antibodies or using an electron microscope to examine the cells [2, 8].

Additional Diagnostic Tests

In some cases, additional diagnostic tests may be necessary to rule out other conditions or to determine the exact type of tumor.

• Thyroid Ultrasound: A thyroid ultrasound can help identify any abnormalities in the thyroid gland that may be related to a NET [3].
• Calcitonin Levels: Measuring calcitonin levels in the blood can help diagnose medullary thyroid cancer, which is a type of NET [3].

References

[1] by Y Sanli · 2018 · Cited by 191 [2] by A Ferlito · 2009 · Cited by 208 [3] by T Feola · 2020 · Cited by 18 [4] How are neuroendocrine tumors diagnosed? · Biochemical tests: These tests measure the amount or activity of a particular enzyme or protein in your blood or urine ... [5] Computer tomography (CT) scan. CT scans are most useful for detecting the stage of the cancer being diagnosed. [6] by LP Kumar · Cited by 10 [7] A rare head and neck tumor characterized by an epithelial neoplasm with evidence of neuroendocrine differentiation, typically located in the supraglottic larynx ... [8] by EJ Chung · 2008 · Cited by 20

Treatment Options for Laryngeal Neuroendocrine Tumors

Laryngeal neuroendocrine tumors (NETs) are rare and can be challenging to treat. While surgery is often the primary treatment, drug therapy plays a crucial role in managing symptoms and slowing tumor growth.

Somatostatin Analogs (SSAs)

• Octreotide LAR and Lanreotide: These SSAs are commonly used to control symptoms and slow tumor growth in patients with laryngeal NETs [10].
• Treatment Goals: SSAs can provide relief from symptoms related to hormone release and stop or slow tumor growth, serving as the backbone of drug therapy for NETs [10].

Chemotherapy

• One of the longest-used treatments: Chemotherapy is a common treatment option for neuroendocrine tumors, including laryngeal NETs [9].
• Interfering with tumor cells: Chemotherapy works by interfering with the tumor's ability to grow and divide, making it an effective treatment option [9].

Other Treatment Options

• Radiation Therapy: Radiation can be used to deliver targeted therapy directly to cancer cells, including those in laryngeal NETs [15].
• PRRT (Peptide Receptor Radionuclide Therapy): One PRRT drug, lutetium Lu 177 dotatate (Lutathera), is used to treat advanced neuroendocrine tumors, including laryngeal NETs [15].

Medications for Hormone Control

• Excess hormone management: If the tumor releases excess hormones, medications can be prescribed to control symptoms and manage hormone levels [11].

It's essential to note that treatment options may vary depending on the individual case, and a multidisciplinary approach is often necessary to determine the best course of treatment.