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We herein report a very rare case of combined small-cell carcinoma (SmCC) of the hypopharynx, with a squamous cell carcinoma (SqCC) element. A 74-year-old man presented with a 3-month history of throat pain and hoarseness. On hypopharyngoscopy, a tumor was identified in the right anterior wall of the piriform sinus and, following examination of a biopsy sample, the lesion was diagnosed as SqCC. Total laryngectomy with bilateral neck dissection was performed and the malignancy was diagnosed as combined SmCC. One month after surgery, concomitant chemoradiotherapy with cisplatin and etoposide was administered. Immunohistochemically, the SmCC element was positive for CD56 and Ki-67 (50.2%), whereas the SqCC element was positive for cytokeratin 34βE12 and Ki-67 (47.5%). Furthermore, the SmCC element was positive for KIT and platelet-derived growth factor α (PDGFRα), while the SqCC element was positive for epidermal growth factor receptor (EGFR) and PDGFRα. By genetic analysis, a silent mutation in the PDGFRα gene was recognized. The expression of KIT, PDGFRα and EGFR in this case provided evidence that combined SmCC may be a candidate for molecular-targeted therapy, although further investigations are required. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma of the head and neck (HNSCC) is the sixth most common type of cancer, affecting ~500,000 individuals worldwide annually. Collagen is the major constituent of the extracellular matrix component in tumors and plays a crucial role in tumor development. The aim of this study was to determine the mRNA expression of type XXI, XXII, XXIII and XXIV α1 collagen (COL21A1, COL22A1, COL23A1 and COL24A1, respectively) in head and neck squamous cell carcinoma (HNSCC) and investigate its correlation with disease progression. This study investigated the mRNA expression levels of COL21A1, COL22A1, COL23A1 and COL24A1 in 70 HNSCC primary samples and 44 matched pairs of tumor and adjacent normal mucosal tissues using quantitative polymerase chain reaction (qPCR). Expression data were compared to the clinicopathological variables in order to determine the correlation between expression and disease progression. Our results demonstrated that the mRNA levels of COL22A1 and COL24A1 were significantly higher in HNSCC tissues compared to those in the corresponding normal tissues from the same individuals (n=44; P<0.001 and P=0.019, respectively). The COL22A1 mRNA levels were found to be significantly associated with lymph node metastasis (P=0.018) and pathological stage (P=0.024), whereas the COL24A1 mRNA levels were significantly associated with tumor size (P=0.045). The high expression levels of COL22A1 and COL24A1 mRNA were statistically correlated with a decrease in disease-free survival (DFS) (log-rank test, P<0.001). The results of the multivariate logistic regression analysis revealed that high expression levels of the COL22A1 and COL24A1 gene pair were associated with a high odds ratio for recurrence of 14.62 (95% confidence interval: 2.77-77.26; P=0.002). Therefore, the upregulation of COL22A1 and COL24A1 mRNA may play a critical role in the progression of HNSCC and provide useful information as a prognostic predictor for HNSCC patients. [ABSTRACT FROM AUTHOR]