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• Re:Mucosal large cell neuroendocrine carcinoma of the head and neck regions:inconsistent data
  Kimihide Kusafuka
  Published on: 18 April 2016
• Mucosal large cell neuroendocrine carcinoma of the head and neck regions:inconsistent data
  Shaodong Yang
  Published on: 18 April 2016

• Published on: 18 April 2016

  Re:Mucosal large cell neuroendocrine carcinoma of the head and neck regions:inconsistent data

  • Kimihide Kusafuka, Chief
  • Other Contributors:
    • Masato Abe, Yoshiyuki Iida, Testuro Onitsuka, Tomohito Fuke, Tomoyuki Kamijo, Takashi Nakajima

  Answers to the letter Dear Dr. Sir. 1. We confirmed that the patient was 79 years-old man on case 2. As the mitosis index and the Ki-67 labeling index were estimated with newly prepared sections, the indices were a bit different. We confirmed that the tumor cells were focally positive for chromogranin-A, but negative for synaptophysin on case 2. 2. Certainly, at the writing step of the review article (ref.3), the progno...

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  Answers to the letter Dear Dr. Sir. 1. We confirmed that the patient was 79 years-old man on case 2. As the mitosis index and the Ki-67 labeling index were estimated with newly prepared sections, the indices were a bit different. We confirmed that the tumor cells were focally positive for chromogranin-A, but negative for synaptophysin on case 2. 2. Certainly, at the writing step of the review article (ref.3), the prognosis of our series of M-LCNEC was relatively good, but the prognosis became worse one year after that time. We concluded that the prognosis of M-LCNEC was relatively worse, like the LCNEC of other organs, in this recent paper (ref. 1). Moreover, we confirmed that three cases of M-LCNEC were positive for thyroid transcription factor(TTF)-1. 3. We confirmed that the age ranged from 52 to 74 years old in our M-LCNEC series and that four patients were alive without disease (31 months, 18 months, 24 months and 90 months).

  Dr. Kimihide Kusafuka, D.D.S., Ph.D. Pathology Division, Shizuoka Cancer Center Hospital and Research Institute

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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• Published on: 18 April 2016

  Mucosal large cell neuroendocrine carcinoma of the head and neck regions:inconsistent data

  • Shaodong Yang, oral pathologist

  Dear Editor,

  I read with interest the recent original article entitled 'Mucosal large cell neuroendocrine carcinoma of the head and neck regions in Japanese patients: a distinct clinicopathological entity' by Kusafuka et al.[1] The patient (Case 2) in this article had been previously reported.[2] I note some discrepancies between these two papers. In this original article, the patient (Case 2) was a 65-year-old...

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  Dear Editor,

  I read with interest the recent original article entitled 'Mucosal large cell neuroendocrine carcinoma of the head and neck regions in Japanese patients: a distinct clinicopathological entity' by Kusafuka et al.[1] The patient (Case 2) in this article had been previously reported.[2] I note some discrepancies between these two papers. In this original article, the patient (Case 2) was a 65-year-old man. The mitotic rate of this tumor was not specified, but >15 per 10 high power fields. Immunohistochemically, the tumor cells were focally positive for chromogranin-A, but negative for synaptophysin. The Ki-67 labeling index was 90.8%[1]. In the case report[2], this patient was a 79-year-old man. The mitotic rate was 13 per 10 high-power fields. The tumor cells were focally positive for synaptophysin (shown in Figure 3c), but negative for chromogranin-A. The Ki-67 labeling index was 82%.

  There are also some discrepancies between this original article and their recent review article[3]. In the review[3], they mentioned that four of their eight mucosal large cell neuroendocrine carcinomas arose in the larynx (supraglottis). The follow up periods were 12-96 months, and only one patient died of disease. The authors concluded that the Japanese cases of mucosal large cell neuroendocrine carcinoma had a better prognosis than that reported in the literature. Three cases were immunopositive for thyroid transcription factor-1. But in this original article[1], four tumors occurred at the larynx, with three at the supraglottis and one at the infraglottis. Three patients died of disease, and one patient died of another disease (shown in Table 2), which led to the conclusion that their Japanese series of large cell neuroendocrine carcinoma also indicated a relatively poor prognosis as that reported in the literature. The follow up periods were 15-90 months (shown in Table 2). Only two cases were immunopositive for thyroid transcription factor-1.

  Discrepancies were also present in this original article[1]. In the section of Results, the age of the eight patients ranged from 52 to 75 years (mean 64.6 years). In the section of Discussion, they stated all the cases in the present series were aged >65 years and the follow up periods of the patients that have been disease-free were 24-108 months. But in Table 2, the age ranged from 52 to 74 years and four patients were alive without disease (31 months, 18 months, 24 months and 90 months after surgery, respectively).

  In conclusion, there are many inconsistent data in these articles concerning mucosal large cell neuroendocrine carcinoma by Kusafuka et al.[1-3] They should verify the original data and make a correction.

  Sincerely, Shaodong Yang. Department of Oral Histopathology, Hainan Medical College, 3 Xueyuan Road, Longhua District, Haikou, China.

  REFERENCES 1. Kusafuka K, Abe M, Iida Y, et al. Mucosal large cell neuroendocrine carcinoma of the head and neck regions in Japanese patients: a distinct clinicopathological entity. J Clin Pathol 2012;65:704-9. 2. Kusafuka K, Asano R, Kamijo T, et al. Large cell neuroendocrine carcinoma of the tongue base: case report of an unusual location with immunohistochemical analysis. Int J Oral Maxillofac Surg 2009;38:296-9. 3. Kusafuka K, Ferlito A, Lewis JS Jr, et al. Large cell neuroendocrine carcinoma of the head and neck. Oral Oncol 2012;48:211-5.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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