Neuroendocrine carcinomas (NEC) of the larynx are rare. The key to dia
gnosis is therefore an increased awareness of such lesions amongst oto
laryngologists and pathologists. A precise histological diagnosis is c
rucial, as the management is different for each NEC sub-type. Advances
in immunohistochemistry have been a great help in this respect. We re
port a typical case of large cell NEC (atypical carcinoid) and highlig
ht the clinical pointers to the histological diagnosis.