Neuroendocrine carcinoma of the larynx.

Neoplasms of the larynx showing neuroendocrine differentiation are uncommon, with less than 100 previously reported cases. These tumors encompass subcategories that have been designated heretofore as "malignant carcinoid" and "oat cell carcinoma" and have been associated with ectopic production of neuropeptides and biogenic amines. We report a case of neuroendocrine carcinoma that arose in the epiglottis in an elderly man, metastasized widely, and was responsible for death. Immunohistochemical studies showed the presence of serotonin, calcitonin, ACTH, met-enkephalin, chromogranin, and neuron-specific enolase within tumor cells, although clinical endocrinopathy was absent. This case is used as a focus for discussion of the spectrum of neuroendocrine tumors of the head and neck, including recommended treatment approaches for such neoplasms.