gms | German Medical Science

Introduction: The heterogeneous entity of neuroendocrine tumors normally originates from the gastrointestinal tract and is subdivided into benign and malign as well as biologicaly active and inactice tumors. Metastases usually occur in the liver or in the regional lymph nodes. Publications of the past 30 years describe three cases of neuroendocrine tumors of the gastrointestinal tract, metastazising to the neck region.

Methods: We report a case of a 50 year-old patient, who presented to his ENT specialist with a feeling of pressure in the right ear, serous otorrhea and a slight swelling of the right neck. The CT-scan showed a parapharyngeal mass on the right side, extending to the parotid gland, the temporal lobe, the epipharynx and the intracranial space.

Results: After transoral biopsy including incision of the pharyngeal mucosa histopathological and immunohistochemical analysis revealed a neuroendocrine tumor with high expression of CD56 and neuron specific enolase (NSE). Somatostatine receptor scintigraphy showed a somatostatine receptor positive focus in the uncinate process of the pancreas. Surgery was not possible because of the diffuse infiltration of the skull base and the cervical structures, therefore radiotherapy using the IMRT was performed. Inspite of therapy the patient died 4 months of to the diagnosis was established.

Conclusion: The present case shows, that despite the heterogeneity of neuroendocrine tumors and the interindividual inhomogeneous growth pattern of these tumors, surgical exstirpation is the therapy of first choice whenever positive.