Introduction: Large cell neuroendocrine carcinoma is a distinct clinicopathlogical entity which is extremely rare among salivary glands. Fine needle aspiration cytology is a valuable tool in the diagnosis of salivary gland tumors but due to extreme rarity of large cell neuroendocrine carcinoma and high grade cytological features this tumor is usually not in the list of high grade carcinomas differentials. We have documented a case of large cell neuroendocrine carcinoma that was misdiagnosed initially as tuberculous parotitis and later on as large cell high grade carcinoma on fine needle aspiration cytology. Case report: A 45 year old male with a painful lump at right parotid and facial nerve weakness was initially misdiagnosed as tuberculous parotitis and treated with anti-tuberculous therapy. Based on fine needle aspiration cytology, he has been treated as high grade carcinoma of parotid. Radical parotidectomy and neck dissection from level 1-5 was performed to be followed by post-operative radiotherapy. Currently patient is alive without disease and on regular follow up. Conclusion: Due to varied morphological and biological behavior of large cell neuroendocrine carcinoma, early diagnosis seems to be an important prognostic factor. Surgery should be considered as the mainstay of treatment supplemented by postoperative radiotherapy and chemo radiotherapy.
Muhammad Faisal, Irfan Haider, Omer Waqas, Muhammad Taqi, Syed Raza Hussain and Arif Jamshed