Figure 2.Contrast-enhanced computed tomography scan showing subglottic tumor with an enhanced pre laryngeal node.
Direct laryngoscopy and biopsy was performed under general anesthesia. The histopathology findings were suggestive for neuroendocrine carcinoma. Microscopic histopathology analysis showed a tumor consist of small size neoplastic cells with acidophilic cytoplasm, coarse chromatin pattern with areas of necrosis and a high mitotic rate (more than 10/mm2).Immunohistochemistry was positive for creatine kinase 7, synaptophysin, chromogranin, Cluster of differentiation (CD) 56, and ki67(Figure 3). The Ki-67 index was 45%. These findings were consistent with the diagnosis of small cell NEC.