Laryngeal Neuroendocrine Tumour: A Rare Case Report and Review of Literature

Neuroendocrine tumours consist of diverse group of neoplasms. They are the most common type of nonsquamous laryngeal malignancies (0.6-1%) and mainly affect males. Atypical carcinoid is the most common type and typical carcinoid being the rarest. A 60 year male patient presented to the ENT OPD with the chief compliant of irritation in the throat and foreign body sensation since past 6 months. He was a chronic smoker. On indirect laryngoscopy and 70 degree scopy there was a single well defined smooth globular mass over right arytenoid. Both the vocal cords were mobile. Rest of the larynx was normal and there was no pooling of saliva. Neck examination revealed no lymphadenopathy. Wide local excision was done and histopathology was suggestive of neuro endocrine tumour with immunohistochemistry suggestive of cells expressing chromogranin and synaptophysin diffusely and Ki67 was 10-12%. Tumour margins were free. Postoperative 70 degree scopy was absolutely normal with no residual lesion. The first atypical laryngeal carcinoid was described by Goldmann et al in 1969. They are characterised into neural (Paraganglioma) and epithelial types (atypical carcinoid, typical carcinoid, small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma). Most common site of involvement in larynx is supraglottis. Clinical manifestations include dysphagia, hoarseness, odynophagia, dyspnoea and haemoptysis. The definitive diagnosis depends on histopathology according to the histological and immunohistochemistry features of the tumour type. The treatment of choice in atypical carcinoid is wide local excision or supraglottic laryngectomy ( as most tumours are supraglottic in location). Laryngeal neuroendocrine tumours of the larynx are extremely uncommon. Multidisciplinary approach is required to treat the tumours efficiently.