Laryngeal Chondrosarcoma: An Exceptional Localisation of a Not Unfrequent Bone Tumor

Abstract

After osteosarcoma, chondrosarcoma is the second most common primary bone tumor accounting for 26% of all malignancies. In the laryngeal region however, chondrosarcomas are rather rare. Only 300 cases are reported in literature. Considering laryngeal chondrosarcoma, about 75% occur in the cricoid cartilage, whereas 20% occur in the thyroid cartilage. In this paper we report a case of thyroidal chondrosarcoma, and based on a thorough literature search we suggest some practical guidelines concerning diagnosis and therapy.

Laryngeal Chondrosarcoma: A Case Report

“…It mainly develops in cricoid cartilage [75% of cases] [2][3][4], rarely in thyroid cartilage (20% of cases) or arytenoid cartilage (3% of cases) [3,5,6]. It generally occurs in patients aged between 50 and 70 years, with male predominance [2,6,7]. Laryngeal chondrosarcoma produces dyspnea, dysphagia, odynophagia, hoarseness, and airway obstruction [5,8].…”

“…A variably dense, expansile lesion with characteristic ''popcorn'' calcifications is usually present [5,9,10]. Adjacent soft tissue or bone can differentiate from chondroma [2,6] and metastatic potential is rare. Grade 2 chondrosarcomas show increased cellularity with rare mitotic forms and the metastatic potential represents only 10% [6].…”

“…Grade 3 chondrosarcomas, are hypercellular with multinucleated chondrocytes and increased mitotic activity [5]; While there has been documentation of 71% of high-grade laryngeal chondroasarcomas showing metastases. [5,13] Surgery is the treatment of choice [2,5]. Grade 2 and 3 chondrosarcomas may be treated by partial surgery with adequate safety margins.…”

“…Chondrosarcoma is considered poorly sensitive to radiation therapy. It may be considered where surgery is contraindicated, or postoperatively in case of incomplete exeresis [2,5,6]. Chemotherapy has no role in this indication [7].…”

“…Overall five-year survivorship ranges from 79% to 90% [11,14]. Metastasis or recurrence is rare when the surgery is complete, it occurs in 8% to 14% of cases [1,2,11].…”