Giant laryngeal neuroendocrine neoplasm causing airway obstruction: A case report and literature review

Abstract

Rationale: Laryngeal neuroendocrine neoplasm (NEN) is a rare and heterogeneous disease that originates from neuroendocrine cells. It mainly occurs in middle-aged and elderly men. Due to the lack of specific clinical and imaging manifestations, diagnosis and treatment of the disease pose a challenge. Therefore, a consensus on the diagnosis and treatment of the disease is necessary. By discussing this case, we will be able to gain further insight into laryngeal NEN and will be able to provide some recommendations for the future management of this rare disease. Patient concerns: A 67-year-old man was admitted to our department with a history of sore throat and dyspnea. After admission, the patient experienced acute airway obstruction and experienced an emergency bedside tracheotomy. Diagnoses: Flexible fiberoptic laryngoscopy and enhanced CT showed a cauliflower-like mass in the left supraglottic region and obstructed most of the laryngeal cavity. We biopsied the mass, and the pathology showed a poorly differentiated adenocarcinoma. Interventions: A horizontal hemilaryngectomy and left neck dissection were performed. At 4 weeks after the operation, the patient underwent chemotherapy and radical radiotherapy. Outcomes: After a 1-year postoperative follow-up, the patient recovered well and showed no signs of recurrence. Lessons: Laryngeal neuroendocrine neoplasm is very rare, early diagnosis remains difficult. Radical surgery combined with postoperative chemoradiotherapy is currently the most appropriate treatment.