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Case Reports
. 2016 Jun;10(2):252-5.
doi: 10.1007/s12105-015-0648-7. Epub 2015 Aug 21.

Undifferentiated Laryngeal Carcinoma with Pagetoid Spread

Sulen Sarioglu  1 , Ersoy Dogan  2 , Yasemin Sahin  3 , Evren Uzun  3 , Recep Bekis  4 , Emel Ada  5 , Ozgul Sagol  3 , Fadime Akman  6
Affiliations
Case Reports

Undifferentiated Laryngeal Carcinoma with Pagetoid Spread

Sulen Sarioglu et al. Head Neck Pathol. 2016 Jun.

Abstract

Pagetoid spread, is used to define intraepithelial spread of cancer cells, when a massive carcinoma is identified beneath the basal membrane. There are only few reports of pagetoid spread at the head and neck region. Herein a 74 year old male patient with bilateral transglottic laryngeal high grade malignant epithelial tumor with pagetoid spread is presented. The tumor was located at the submucosa and there was spread of the CK7 and CK19 positive tumor cells into the non neoplastic mucosa, which was CK5/6 positive, sparing the basement membrane, creating a typical pagetoid pattern. Radiographic and positron emission tomography scan examination of the patient was unremarkable at presentation other than the laryngeal and neck lesions; but extensive systemic metastasis developed at 6 months following operation. To the best of our knowledge no epithelial malignancy with pagetoid spread was described at the larynx. Pagetoid spread may be a hallmark of very aggressive behavior in laryngeal carcinoma.

Keywords: Aggressive behavior; Larynx; Pagetoid spread; Undifferentiated carcinoma.

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Figures

Fig. 1
Fig. 1
Undifferentiated carcinoma (H&E, original magnification ×40)
Fig. 2
Fig. 2
Cytokeratin 19 expression at the mucosa limited to the neoplastic cells spreading in a pagetoid fashion and the submucosal tumor (CK19, original magnification ×2)
Fig. 3
Fig. 3
Pagetoid spread of CK5/6 negative tumoral cells at the laryngeal mucosa (CK5/6, original magnification ×40)
Fig. 4
Fig. 4
Predominantly right sided transglottic laryngeal carcinoma, total laryngectomy
Fig. 5
Fig. 5
Pagetoid spread of tumoral cells at the laryngeal mucosa and excretory ducts (H&E, original magnification ×10)
See this image and copyright information in PMC

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