Extrapulmonary small cell carcinoma localized in lymph nodes: Is it a different clinical entity?

Figures & data

Table I.  Clinicopathological characteristics and clinical course in patients with extrapulmonary small cell localized in lymph nodes.

No.	Age (year)	Gender	Smoking	Primary region	Stage	Treatment	Response	Recurrence site	PFS	Status	OS (month)	Reference
1	52	M	yes	submandibular	LD	RT, RT+ 46 Gy bilateral neck	CR, CR	No	—	Alive	84+	Remmick et al.^2
2	60	M	?	submandibular	LD	RND+5860 rads RT, WBR+EB, orişektomi	CR, CR	Nasal, brain servical, testis	24,	DOD	36	Kasimis et al.^13
3	72	M	?	submandibular	LD	IB, EB	IS, CS	No change, no recurrence	40+	Alive	40+
4	?	?	?	cervical	LD	CDE+ 6000cGy RT	CR	No	12+	Alive	12+	Van der Gaast et al.^8
5	?	?	?	cervical	LD	CDE	CR	local	?	AWD	22+
6	?	4M/1F	4 yes/ 1 no	submandibular	LD	CS	CR	no	36+	Alive	42+	Galanis et al.^6
7	?			submandibular	LD	CS	CR	no	36+	Alive
8	?			submandibular	ED	RT? CT?	?	?	?	Alive?
9	?			inguinal	LD	CS	CR	no	36+	Alive
10	?			retroperitoneal	ED	RT? CT?	?	?	?	Alive?
11	75	F	no	?	LD	CE+39 Gy RT	CR	no	–	Alive	47.6+	Lo Re et al.^9
12	20	M	yes	?	ED	CEV/CE, 30 Gy RT+CS, PEI	NC, CR	Retroperitoneal Lymph nodes	10	AWD	18.6+
13	60	M	no	hepatic hilus	ED	CE+RT, CAV	NC	Abdominal lymph nodes	3,6	DOD	9.1
14	40	M	?		LD	CE+RT	CR	Liver, LN	42	DOD	44	Kurt et al.^7
15	58	F	?		LD	CE+RT	CR	bone	13	DOD	14.5
16	?	?	?	Abdominal Lymph nodes	?	?	?	?	?	?	?	Kim et al.^11
17–24	?	6M/2F	?	?	7LD/1ED	?	?	?	?	?	?	Haider et al.^4
25	49	M	No	cervical	LD	RT+CMC-VAP	CR	no	15+	Alive	15+	Levenson et al.^10
26	43	M	Yes	Mediastinal, retroperitoneal	ED	CE	NC			AWD	72+	Cicin et al. ^5
27	77	F	?	Inguinal	LD	CS	CR	no			12+	Hainsworth et al.^12
28	61	M	?	cervical	LD	CAV+RT	CR	no			100+

PFS: Progresion free survival, OS: overall survival, F: female, M: male, RT: radiotherapy, RND: radical neck dissection, WBR: whole brain radiotherapy, EB: excisional biopsy, IB: incisional biopsy, IS: incomplete surgery, CS: curative surgery, CT: chemotherapy, CE: cisplatin/etoposide, CDE: cyclophosphamide, doxorubicin, etoposide; CAP: cyclophosphamide, adriamycin, cisplatin; CE: cisplatin, etoposide; CEV: Cyclophosphamide, epidoxorubicin, vincristine; CAV: cyclophosphamide, doxorubicin, vincristine; PEI: cisplatin, etoposide, ifosfamide.LD: limited disease, DOD: dead of disease, ED: extensive disease, PR: partial response, NC: no change, CR: complete response, AWD: alive with disease.

Table II.  Results of patients with small cell carcinoma localized in lymph nodes.

Features	Results
Age (n: 12)
Mean	56
Range	(range, 20–77 years).
Male/female ratio (n: 25)	18 (72%)/ 7 (28%)
Location in region of lymph nodes (n: 16)
Submandibular	6 (37.,5%)
Cervical	4 (25%)
Inguinal	2 (12.,5%)
Abdominal	2 (12.,5%)
Retroperitoneal	2 (12.,5%)
Smoking (n: 11)	7 (64%)
Stage (n: 27)
Limited	21 (77%)
Extensive	6 (23%)
Brain metastasis (n: 19).	1 (5%)
Response to chemotherapy (n: 11)
Limited (n:6)	6 complete (100/%)
Extensive (5)	4 stable or partial (80%)/1 progression (20%)
Median survival (n: 19)
Limited (n:14)	42+ months (range, 12–100)
Extensive (n:5)	42+ months (range, 9.1–80)
Treatment (n: 16)
Surgery	5
Radiation	10 (or 12)
Chemotherapy	11

n: number of patients who underwent an evaluation.

Figure 1.  (a) Tumor cells haphazardly arranged in-between fibrous tissue, with scant cytoplasm and round to oval hyperchromatic nuclei. The crashing artifact of the tumor cells is prominent (HEx100). (b) Diffuse intense staining of the tumor cells for chromogranin-A (Chromogranin-Ax100).