Search

Extrapulmonary small cell carcinomas (EPSCC) are a rare subtype of neuroendocrine tumours which have been documented to arise from a multitude of sites and treatment outcomes are disappointing. The most common site involved in the head and neck region is the larynx and the oropharynx as a primary site has been infrequently reported. The patient presented with bilateral neck swelling and an ulcerated lesion was noted in the base of tongue (BOT). A biopsy revealed small cell carcinoma (SCC) and was confirmed with immunohistochemistry. The final diagnosis after workup was SCC of BOT stage IVc. He received induction chemotherapy to which the tumour responded partially, followed by curative intent chemoradiotherapy and adjuvant chemotherapy. The patient achieved a radiological complete response to treatment and almost all treatment-induced toxicities resolved. An aggressive approach to managing EPSCC is possible with modern radiotherapy techniques, with tolerable treatment-induced toxicities., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None declared.

A 47-year-old woman presented with symptoms of low back pain and weakness in bilateral lower limbs. MRI of the spine revealed a mass arising from T11 vertebra involving neural foramina at bilateral T11-12 and right T10-11 levels with extension to the right paravertebral region. Suspecting a nerve sheath tumour, she underwent posterior spinal decompression, stabilisation and debulking, following which her neurological symptoms resolved. Histopathological and immunohistochemical evaluation revealed a leiomyosarcoma. A month later she developed sudden paraparesis and MRI revealed an increase in size of the tumour with cord compression and displacement. She underwent a repeat spinal decompression and debulking procedure after which she received adjuvant radiotherapy via volumetric modulated arc therapy, to a total dose of 45 Gy in 25 fractions over 5 weeks. MRI performed 2 months later revealed complete response and she is disease free for the past 5 months., (2017 BMJ Publishing Group Ltd.)

A 47-year-old woman presented with symptoms of sharp pain over the left anterior thigh with radiation from the groin to the knee. She subsequently developed numbness in that region and reduced motor strength in extensors of the left knee. Plain radiography of the spine and knee was normal. An MRI of the spine revealed an irregular extramedullary mass with intradural and extradural components, extending from the L3 to L5 vertebrae. She underwent a laminectomy and posterior spinal decompression based on a working diagnosis of nerve sheath tumour. Histopathology revealed a primary bone lymphoma. A positron emission tomography CT (PET-CT) performed as part of the staging workup revealed fluorodeoxyglucose avid lesions in the spine and left femur. She received immunochemotherapy (Rituximab-Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisone) for eight cycles with an interim PET-CT revealing complete response. Subsequently, she received consolidation radiotherapy, 36 Gy in 20 fractions over 4 weeks to both lesions. She is now disease-free on follow-up for the past 1 year., (2017 BMJ Publishing Group Ltd.)