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Improved survival for stage IV sinonasal small cell neuroendocrine carcinoma treated with chemotherapy and anti-PD-L1 therapy
  1. Margaret Selesky1,
  2. Omar Elghawy2 and
  3. Varinder Kaur1
  1. 1Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA
  2. 2Department of Internal Medicine, division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA, USA
  1. Correspondence to Dr Varinder Kaur; vk4q{at}


Small cell carcinoma neuroendocrine type (SCCNET) is a rare tumour of the head and neck. Due to its infrequency, a paucity of data exists on optimal treatment, and the current paradigm for advanced SCCNET mirrors that of extensive small cell lung cancer. Increasingly, the treatment for extrapulmonary small cell carcinomas like SCCNET has incorporated immune checkpoint inhibitors (ICIs), although the utility of ICIs is not fully understood. We present a case of stage IVC sinonasal SCCNET in a woman in her 90s, who experienced eyelid swelling and unintentional weight loss. After diagnostic work-up, she was treated with etoposide, carboplatin and atezolizumab with a complete response to therapy. The patient had one episode of inflammatory polyarthropathy which resolved with steroids but otherwise tolerated treatment well and is now living with an overall survival of greater than 27 months. This case highlights the long-term efficacy of combination ICIs and chemotherapy in the treatment of SCCNET.

  • Cancer intervention
  • Head and neck cancer
  • Immunological products and vaccines

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  • Contributors MS, OE and VK wrote and edited the manuscript. VK involved in clinical care of the patient including treatment, monitoring and follow-up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.