Extrapulmonary small cell carcinoma arising from the pharynx is rare. We have experienced 4 cases of pharyngeal small cell carcinoma. All the patients were male, and the mean age was 66 years old. The primary site was the oropharynx in 2 cases and the hypopharynx in 2 cases. All the patients initially underwent surgical resection, followed by chemotherapy or chemoradiotherapy. Three patients died because of distant metastasis. One patient is still alive without disease. Twentyfour cases of pharyngeal small cell carcinoma have been reported to date. An analysis of these 28 cases, including our 4 cases, revealed that 20 of the cases had died because of pharyngeal small cell carcinoma. Thus, pharyngeal small cell carcinoma appears to be associated with a relatively poor prognosis similar to that of pulmonary small cell carcinoma. Patients with T3/4 or metastatic diseases have an especially poor prognosis. When the primary site is resectable with minimum invasion, surgery followed by chemotherapy or chemoradiotherapy might offer a better chance of inhibiting local recurrence, compared with other strategies.
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