Advanced nasal neuroendocrine carcinoma: response to treatment and management of anemia in a palliative patient
Keywords:
neuroendocrine carcinoma, iron deficiency anemia, chemotherapy
Abstract
Advanced nasal neuroendocrine carcinoma is a rare malignant tumor originating in the nasal cavity and paranasal sinuses. It is characterized by its high aggressiveness and tends to present in advanced stages, with infiltration of underlying bone structures. Diagnosis is confirmed by biopsy and histology, which usually shows poor neuroendocrine differentiation. Treatment is usually multimodal, including chemotherapy, radiotherapy, and in some cases, surgery. Neoadjuvant chemotherapy with cisplatin and etoposide improves survival in these patients.
We present the case of a 54-year-old female patient with stage IV A nasal neuroendocrine carcinoma, in palliative treatment with chemotherapy based on cisplatin and etoposide, and management of associated iron deficiency anemia. The patient showed a positive response to treatment, with scheduled follow-up to monitor her hematologic status and adjust supportive treatment.
References
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3. Zhao Q, Wei J, Zhang Ch, Meng L, Wang B, Gao L, et al. Large-cell neuroendocrine carcinoma of nasal cavity and paranasal sinuses after successful curative therapy: a case report and literature review. Onco Targets Ther [Internet]. 2019 [cited 2024 Jun 8]; 12:2975–80. Available from: https://pubmed.ncbi.nlm.nih.gov/31114241/. doi: 10.2147/OTT.S195052
4. Saha S, Patil VM, Noronha V, Menon N, Kumar Singh A, Patlekar G, et al. Real world data on long term outcome of neoadjuvant chemotherapy in locally advanced esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation - Results from a single centre study. Oral Oncol. 2023;144: 106486. doi: 10.1016/j.oraloncology.2023.106486
5. Fitzek MM, Thornton AF, Varvares M, Ancukiewicz M, Mcintyre J, Adams J, et al. Neuroendocrine tumors of the sinonasal tract. Results of a prospective study incorporating chemotherapy, surgery, and combined proton-photon radiotherapy. Cancer [Internet]. 2002 [cited 2024 Jun 8];94(10):2623–34. Available from: https://pubmed.ncbi.nlm.nih.gov/12173330/. doi: 10.1002/cncr.10537
6. Cabezas-Camarero S, García-Barberán V, Benítez-Fuentes JD, Sotelo MJ, Plaza JC, Encinas-Bascones A, et al. Clinical behavior, mutational profile and T-cell repertoire of high-grade neuroendocrine tumors of the head and neck. Cancers (Basel) [Internet]. 2023 [cited 2024 Jun 8];15(9): 2431. Available from: https://pubmed.ncbi.nlm.nih.gov/37173898/. doi: 10.3390/cancers15092431
7. Ohmoto A, Sato Y, Asaka R, Fukuda N, Wang X, Urasaki T, et al. Clinicopathological and genomic features in patients with head and neck neuroendocrine carcinoma. Mod Pathol [Internet]. 2021 [cited 2024 Jun 8];34(11):1979–89. Available from: https://pubmed.ncbi.nlm.nih.gov/34247193/. doi: 10.1038/s41379-021-00869-9
8. Rosenthal DI, Barker Jr JL, El-Naggar AK, Glisson BS, Kies MS, Diaz Jr EM, et al. Sinonasal malignancies with neuroendocrine differentiation: patterns of failure according to histologic phenotype. Cancer [Internet]. 2004 [cited 2024 Jun 8];101(11):2567–73. Available from: https://pubmed.ncbi.nlm.nih.gov/15517582/. doi: 10.1002/cncr.20693
9. van der Laan TP, Iepsma R, Witjes MJH, van der Laan BFAM, Plaat BEC, Halmos GB. Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma: The importance of differentiation grade in determining treatment strategy. Oral Oncol [Internet]. 2016 [cited 2024 Jun 8]; 63:1–9. Available from: https://pubmed.ncbi.nlm.nih.gov/27938993/. doi: 10.1016/j.oraloncology.2016.10.002
10. Busti F, Marchi G, Ugolini S, Castagna A, Girelli D. Anemia and iron deficiency in cancer patients: Role of iron replacement therapy. Pharmaceuticals (Basel) [Internet]. 2018 [cited 2024 Jun 8];11(4):94. Available from: https://pubmed.ncbi.nlm.nih.gov/30274354/. doi: 10.3390/ph11040094
11. Aapro M, Österborg A, Gascón P, Ludwig H, Beguin Y. Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron. Ann Oncol [Internet]. 2012 [cited 2024 Jun 8];23(8):1954–62. Available from: https://pubmed.ncbi.nlm.nih.gov/22575608/. doi: 10.1093/annonc/mds112
12. Nandakumar S, Singh N, Tharani AR, Pankiw M, Brezden-Masley Ch. Intravenous iron and iron deficiency anemia in patients with gastrointestinal cancer: A systematic review. PLoS One [Internet]. 2024 [cited 2024 Jun 8];19(5): e0302964. Available from: https://pubmed.ncbi.nlm.nih.gov/38776289/. doi: 10.1371/journal.pone.0302964
13. Rodgers GM, Becker PS, Blinder M, Cella D, Chanan-Khan A, Cleeland Ch, et al. Cancer- and chemotherapy-induced anemia. J Natl Compr Canc Netw [Internet]. 2012 [cited 2024 Jun 8];10(5):628–53. Available from: https://pubmed.ncbi.nlm.nih.gov/22570293/. doi: 10.6004/jnccn.2012.0064
14. DeLoughery TG, Jackson ChS, Ko CW, Rockey DC. AGA Clinical practice update on management of iron deficiency anemia: Expert review. Clin Gastroenterol Hepatol [Internet]. 2024 [cited 2024 Sep 8];22(8):1575–83. Available from: https://pubmed.ncbi.nlm.nih.gov/38864796/. doi: 10.1016/j.cgh.2024.03.046
