An endoscopy at Tam Anh General Hospital Hanoi identified a 2x1,5 cm red, proliferative tumor in Mr. Phi's soft palate, obstructing the pharyngeal isthmus. Master Doctor Nguyen The Thu, from the Oncology Department, recommended laser surgery to excise the tumor and perform lymph node dissection, with a pathological examination to determine its exact nature.

Pathological examination revealed a high-grade carcinoma, though further immunohistochemistry was needed for precise classification. The tests confirmed Mr. Phi had small cell neuroendocrine carcinoma, originating in the soft palate. Crucially, no cancer cells were found in the surgical margins or cervical lymph nodes, and the disease was staged as pT1N0M0, indicating no distant metastasis.

Doctor The Thu advises Mr. Phi on his treatment plan. *Photo: Tam Anh General Hospital*

Due to the high recurrence risk associated with this aggressive cancer subtype, even with clear surgical margins and no cancer cells in the cervical lymph nodes, doctors adjusted the post-surgical treatment strategy. Instead of the initially planned complete tumor excision, Mr. Phi was prescribed adjuvant chemotherapy. This aims to target any microscopic cancer cells that might remain, thereby reducing the risk of disease recurrence.

Neuroendocrine carcinoma originates from cells exhibiting neuroendocrine differentiation. The small cell subtype, in particular, is highly malignant, invading and metastasizing quickly, and can manifest anywhere in the body. Most primary sites are found in the gastrointestinal tract (62-67%) and lungs (22-27%).

Patients should seek medical attention if they experience unusual symptoms in the mouth or throat, such as difficulty swallowing, a sensation of a lump, or persistent pain. Early detection facilitates less invasive treatment options and reduces the risk of recurrence.

Hieu Nguyen

*Patient's name has been changed