Collision of Hypopharyngeal Small-Cell Neuroendocrine Carcinoma and Laryngeal Squamous Cell Carcinoma at the Aryepiglottic Fold - Case Report and Review of Literature

Sep 22, 2026

Collision tumors are neoplasms in which two histologically different, topographically independent tumors form one mass. This paper reports a rare laryngeal collision carcinoma combining squamous cell carcinoma and small-cell neuroendocrine carcinoma at the aryepiglottic fold. A 72-year-old patient presented with hoarseness, dyspnea, and dysphagia, with CT showing a right-sided laryngeal tumor. Surgery included total laryngectomy, partial pharyngectomy, and right thyroidectomy with selective neck dissection. Histology and immunohistochemistry demonstrated distinct components. Multiple biopsy sampling is essential, though treatment guidelines remain difficult due to histologic differences.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Introduction

Case Report

Diagnosis/Treatment

Conclusions

Case Reports in Pathology CASE REPORT OPEN ACCESS Collision of Hypopharyngeal Small-Cell Neuroendocrine Carcinoma and Laryngeal Squamous Cell Carcinoma at the Aryepiglottic Fold: Case Report and Review of Literature Neda Mladenovic1 | Sasa Jakovljevic1, 2 | Nada Tomanovic2 , 3 | Katarina Jovanovic1 | Nemanja Radivojevic1, 2 | Djurdjina Kablar4 | Ana Marija Tomic3 1Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia | 2Faculty of Medicine, University of Belgrade, Belgrade, Serbia | 3Institute of Pathology, Belgrade, Serbia | 4Department for Pathology, Pathohistology and Medical Cytology, University Clinical Centre of Serbia, Belgrade, Serbia Correspondence: Neda Mladenovic ([nedamladenovic995@gmail.com](nedamladenovic995@gmail.com)) Received: 3 November 2024 | Revised: 21 February 2026 | Accepted: 19 March 2026 Academic Editor: Suraiya Saleem Keywords: collision tumor | immunohistochemistry | larynx | neuroendocrine carcinoma | squamous cell carcinoma ABSTRACT Background: Collision tumors are neoplasms in which two histologically different and topographically independent tumors are joined within the same mass. The aim of this paper is to present a rare case of collision carcinoma of the larynx (squamous cell and small-cell neuroendocrine carcinoma) . Case Report—Diagnosis/Treatment: A 72-year-old patient was reported to our clinic because of hoarseness, dyspnea, and dysphagia. Neck CT showed a right-sided laryngeal tumor. The patient underwent total laryngectomy, partial pharyngectomy, and right-sided thyroidectomy with bilateral selective neck dissection. A clear collision of two morphologically and immunohistochemically different components of the tumor was seen on the sections sampled from the aryepiglottic fold. Conclusions: This case highlights the critical importance of obtaining multiple samples during tumor biopsy and emphasizes the role of detailed immunohistochemical staining. Considering the differences in histology, it is difficult to propose guidelines for treatment of these cancers. 1 | Introduction Laryngeal carcinoma is the third most common malignancy occurring in the head and neck region worldwide, with a male to female ratio of approximately 7:1 [1] . The majority of these tumors are of squamous cell origin (about 95% of all cases) with the glottis as the most common site of involvement [1, 2] . Neuroendocrine carcinomas of the larynx are extremely rare, comprising about 0.5% of all laryngeal tumors and are most often found in the supraglottis [2 , 3] . Collision tumors are defined differently in the literature and final compromise has not yet been reached regarding their definition. The accepted definition is that they are neoplasms in which two histologically different and topographically independent tumors are joint within the same mass [3] . They can be found in all parts of the body, including the head and neck region, in which they are very rare. The most common location in this region is the thyroid gland. Very few cases of laryngeal collision tumors composed of squamous cell carcinoma and small-cell neuroendocrine carcinoma have been reported in the literature, highlighting the rarity of this entity [3, 4, 5] . The aim of this paper was to present an extremely rare case of collision carcinoma of the larynx (squamous cell and small-cell neuroendocrine carcinoma) in a 72-year-old patient. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Copyright © 2026 Neda Mladenovic et al. Case Reports in Pathology published by John Wiley & Sons Ltd. Case Reports in Pathology, 2026; 2026:6630405 1 of 6 [https://doi.org/10.1155/crip/6630405](https://doi.org/10.1155/crip/6630405) 2 | Case Report A 72-year-old patient was referred to the otolaryngology department

FAQs

What is a collision tumor in pathology?

A collision tumor consists of two histologically different, topographically independent tumors that are joined within the same mass. The concept and terminology can vary across literature, but this definition is widely accepted.

What symptoms and imaging findings were reported for the patient?

The patient had hoarseness, dyspnea, and dysphagia for three months. Neck CT demonstrated a right-sided laryngeal tumor involving supraglottic and glottic areas and the right aryepiglottic fold and pyriform sinus.

How were diagnosis and tumor characterization confirmed?

Two samples were taken for pathohistological analysis, followed by immunohistochemical staining. The sections showed a clear collision between two morphologically and immunohistochemically distinct tumor components.

Why are treatment guidelines difficult for these cancers?

Because the two components differ in histology, the paper notes that it is difficult to propose unified treatment guidelines. The case also emphasizes careful sampling and detailed immunohistochemical evaluation.

Sep 22, 2026

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