Surgical palliation in poorly differentiated neuroendocrine carcinoma of the hypopharynx: Case report.

BACKGROUND

Primary neuroendocrine carcinomas (NECs) are very rare entities accounting for 0.49% of all malignancies. Within the head and neck, the most common sites are the larynx and paranasal sinuses, while the hypopharynx is seldom described.

CASE: We present a patient with a poorly differentiated metastatic NEC of the hypopharynx treated palliatively with organ-preserving surgery and post-operative chemotherapy, and literature review for well-documented pure hypopharyngeal NECs. Our patient died of chest infection during chemotherapy, 4 months after surgery.

CONCLUSION

Chemotherapy remains the mainstay of treatment in the presence of metastases with 2-year overall survival of 15.7%. Due to the aggressive nature of poorly differentiated metastatic NECs, surgical management is seldom considered. We report and advocate the successful palliative role of organ-preserving, minimally invasive trans-oral LASER micro-surgery and neck dissection to control loco-regional head and neck disease, safe-guarding better quality of home life, despite limited life expectancy for this condition.