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American Head & Neck Society
July 21-25, 2012
Metro Toronto Convention Centre
Toronto, ON, Canada


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SMALL CELL NEUROENDOCRINE TUMOR OF THE TONGUE; A CASE REPORT

Presentation: P088
Topic: Larynx/Oral Cavity
Type: Poster
Date: Sunday - Tuesday, July 22 - 24, 2012
Session: Designated Poster viewing times
Authors: Raghav Kulkarni, MBChB MRCSlon, Katie Edwards, BDS, James A McCaul, PhD FRCSOMFS FRCS FDSRCPS MBChB BDS
Institution(s): Bradford Royal Infirmary: Bradford teaching hospitals NHS trust

Purpose/Objective: Neuroendorine tumours are rare in the mouth/oral cavity. There is confusion on the classification of these tumours, but nevertheless their aggressive nature is recognised throughout literature and in practice. Merkel cell carcinoma is an unusual primary tumour first described by Toker. It recurs locally and can metastasize regionally. It has been described in skin, however, there are Merkel cells intra orally also. These oral counter parts do differ in structure and expression of proteins such as S100. High grade or poorly differentiated neuroendocrine tumours like merkel cell carcinomas tend to be very aggressive and in attempt to decrease the local recurrence of these tumours a wide excision margin is necessary.
Material/Methods: We present a case of small cell neuroendorine carcinoma in a 75-year-old male on the left lateral aspect of his tongue. In his case we used similar excision margins as that of Merkel Cell carcinoma of the skin to obtain histological clearance.
Results: Histological analysis of the tumour confirmed a primary poorly differentiated neuroendocrine tumour of small cell type. We performed a selective left neck dissection that also confirmed a metastasis to a level III node with no extra capsular spread giving him a T1 N1 M0 classification. Resecting with 2cm clinical margins gave clearance margins of 11.7mm from the invasive tumour to mucosal margin medially and 7.0mm for the deep margin.
Conclusion: The aggressive nature of this tumour type mandates aggressive surgical resection with margins similar to those recommended for skin Merkel cell carcinomas. we advocate a wide excision margin of 2cm to give adequate clearance.

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