The Journal of Laryngology and Otology August 1979. Vol. 93. pp. 835-837
Primary oat cell carcinoma of the larynx M. T. HIGAZI (Southampton) PRIMARY oat cell carcinoma of the larynx is an extremely rare clinical entity. The case described is the fourth recorded in the world literature in the last twenty-five years. Thefirstcase was reported by Olofsson and Van Nostrand in 1972. Ferlito in 1974 reported the second case, and Raghuvir Gelot in 1975 reported the third case. We are reporting a similar case recently seen in the Ear, Nose and Throat Department of Queen Alexandra Hospital in Portsmouth. A female aged forty years was admitted to the hospital in June 1977 with a three-month history of a sensation of a lump in the throat at the level of the thyroid cartilage. There was no accompanying pain, no dysphagia, no loss of weight and no hoarseness of voice. She was smoking twenty cigarettes a day, and she had a past medical history of hysterectomy in 1976 for chronic cervicitis and erosion. She had had several plastic operations on her face following a road traffic accident in 1972. She was married, with two children. Her father died of malignant disease of the bone marrow. Indirect laryngoscopy showed a large, fleshy mass surmounting the right arytenoid and the adjacent part of the aryepiglottic fold. The true vocal cords were clear and had normal mobility. She had no palpable nodes in the neck. The rest of the physical examination was normal, including the chest. Haematological and radiological investigations showed a normal blood picture and normal chest and neck x-rays. Biopsy of the laryngeal tumour was performed under general anaesthetic. This was reported as an oat cell carcinoma (Figs. 1 and 2). Following the histological diagnosis a thorough bronchoscopic examination was performed. This revealed no abnormalities in the tracheo-bronchial tree. A full course of radiotherapy with Cobalt 60 was given as the first choice of treatment. This was followed by complete regression of the tumour. Unfortunately, a few weeks after the completion of radiotherapy the patient developed metastatic lymph nodes in the right deep cervical nodes. A right radical neck dissection was performed. The histology of the specimen showed that fourteen nodes out of sixteen were involved with oat cell carcinomatous deposits.
Discussion Primary oat cell carcinoma of the larynx is one of the rarest tumours of this region. The tumour has a sinister character, with a poor prognosis. It has also a great histological similarity to oat cell carcinoma of the lung and a tendency to metastasize early to the ipsilateral cervical lymph nodes. Summary A case of primary oat cell carcinoma of the larynx in a forty-year-old female has been described. The tumour is rare and extremely aggressive. Surgical treatment and irradiation appear to halt the disease for a short time. 835
836
M. T. HIGAZI
FIG. 1 A low power study showing small cell carcinoma of oat cell type infiltrating beneath intact mucosa.
FIG. 2 Higher magnification.
CLINICAL RECORDS
837
Acknowledgement
I am grateful to Mr. I. Johnstone, F.R.C.S., for his permission to report this case. Department of Otolaryngology, Royal South Hants Hospital, Graham Road, Southampton S09 4PE. REFERENCES FERLITO, A. (1974) Oat cell carcinoma of the larynx. Annals of Otology, Rhinology and Laryngology, 83, 254. OLOFSSON, J., and VAN NOSTRAND, A. W. P. (1972) Anaplastic small cell carcinoma of larynx. Annals of Otology, Rhinology and Laryngology, 81, 284. RAGHUVIR GELOT (1975) Primary oat-cell carcinoma of head and neck. Annals of Otology, Rhinology and Laryngology, 84, 238.
Primary oat cell carcinoma of the larynx M. T. HIGAZI (Southampton) PRIMARY oat cell carcinoma of the larynx is an extremely rare clinical entity. The case described is the fourth recorded in the world literature in the last twenty-five years. Thefirstcase was reported by Olofsson and Van Nostrand in 1972. Ferlito in 1974 reported the second case, and Raghuvir Gelot in 1975 reported the third case. We are reporting a similar case recently seen in the Ear, Nose and Throat Department of Queen Alexandra Hospital in Portsmouth. A female aged forty years was admitted to the hospital in June 1977 with a three-month history of a sensation of a lump in the throat at the level of the thyroid cartilage. There was no accompanying pain, no dysphagia, no loss of weight and no hoarseness of voice. She was smoking twenty cigarettes a day, and she had a past medical history of hysterectomy in 1976 for chronic cervicitis and erosion. She had had several plastic operations on her face following a road traffic accident in 1972. She was married, with two children. Her father died of malignant disease of the bone marrow. Indirect laryngoscopy showed a large, fleshy mass surmounting the right arytenoid and the adjacent part of the aryepiglottic fold. The true vocal cords were clear and had normal mobility. She had no palpable nodes in the neck. The rest of the physical examination was normal, including the chest. Haematological and radiological investigations showed a normal blood picture and normal chest and neck x-rays. Biopsy of the laryngeal tumour was performed under general anaesthetic. This was reported as an oat cell carcinoma (Figs. 1 and 2). Following the histological diagnosis a thorough bronchoscopic examination was performed. This revealed no abnormalities in the tracheo-bronchial tree. A full course of radiotherapy with Cobalt 60 was given as the first choice of treatment. This was followed by complete regression of the tumour. Unfortunately, a few weeks after the completion of radiotherapy the patient developed metastatic lymph nodes in the right deep cervical nodes. A right radical neck dissection was performed. The histology of the specimen showed that fourteen nodes out of sixteen were involved with oat cell carcinomatous deposits.
Discussion Primary oat cell carcinoma of the larynx is one of the rarest tumours of this region. The tumour has a sinister character, with a poor prognosis. It has also a great histological similarity to oat cell carcinoma of the lung and a tendency to metastasize early to the ipsilateral cervical lymph nodes. Summary A case of primary oat cell carcinoma of the larynx in a forty-year-old female has been described. The tumour is rare and extremely aggressive. Surgical treatment and irradiation appear to halt the disease for a short time. 835
836
M. T. HIGAZI
FIG. 1 A low power study showing small cell carcinoma of oat cell type infiltrating beneath intact mucosa.
FIG. 2 Higher magnification.
CLINICAL RECORDS
837
Acknowledgement
I am grateful to Mr. I. Johnstone, F.R.C.S., for his permission to report this case. Department of Otolaryngology, Royal South Hants Hospital, Graham Road, Southampton S09 4PE. REFERENCES FERLITO, A. (1974) Oat cell carcinoma of the larynx. Annals of Otology, Rhinology and Laryngology, 83, 254. OLOFSSON, J., and VAN NOSTRAND, A. W. P. (1972) Anaplastic small cell carcinoma of larynx. Annals of Otology, Rhinology and Laryngology, 81, 284. RAGHUVIR GELOT (1975) Primary oat-cell carcinoma of head and neck. Annals of Otology, Rhinology and Laryngology, 84, 238.
