Small cell carcinoma of the head and neck: a single institution's experience and review of the literature.

OBJECTIVES: It is well known that small cell carcinoma (SmCC) arising at extrapulmonary sites leads to a poor prognosis for patients. Owing to the infrequency of primary SmCC of the head and neck, it is very unlikely that any large, controlled study will ever be performed. For this reason, recommendations for the treatment of SmCC arising in the head and neck are based primarily on retrospective data from various small case series. PATIENTS AND METHODS: We report five patients with SmCC of the head and neck seen between 2001 and 2007. In two patients, the SmCCs are in the larynx; in another two patients, in the sinonasal region; and in one patient, in the tonsil. RESULTS: Four patients accepted concurrent chemoradiation therapy (CCRT). Their outcomes are as follows: two patients died, one has adrenal and bone metastasis but is still alive, and one shows no evidence of disease after treatment. One patient refused CCRT and died within 6 months. CONCLUSIONS: The prognosis for patients with primary SmCC of the head and neck is generally poor. Treatment most often involves a combination of radiotherapy and chemotherapy, and hope for improved outcomes hinges principally on the development of improved chemotherapies and other systemic treatments.