Laryngeal inflammatory myofibroblastic tumor (IMT): a case report and review of the literature

Abstract

BackgroundThis case report is interesting as cases of children with laryngeal inflammatory myofibroblastic tumor are not common and previously had been presented as isolated case reports. This is the first case report in Asia describing a laryngeal inflammatory myofibroblastic tumor and its removal using an endoscopic approach.Case presentationOur patient is a 12-year-old Malay girl from Singapore who presented with hoarseness without respiratory distress. The initial impression was that of a granuloma or a papilloma. We did a biopsy, which confirmed the histology to be inflammatory myofibroblastic tumor, and a magnetic resonance imaging scan showed a contrast-enhanced lesion. The lesion was excised completely using an endoscopic approach. The child was discharged well on the first postoperative day and she has been on follow-up for a year in the clinic.ConclusionsThis report highlights the importance of understanding the differential diagnosis for a child with hoarseness. It is not uncommon for a pediatrician, a general practitioner, and a pediatric otolaryngologist to see a child presenting with hoarseness. In most cases, the diagnosis made would be screamer’s nodules, which is commonly seen in children. In a small group, recurrent respiratory papillomatosis form the diagnosis. Over the past few years, the cases of recurrent respiratory papillomatosis have decreased significantly. Laryngeal tumors are not common in children. However, we must maintain a high index of suspicion when we have a child with hoarseness who does not improve with speech therapy and watchful waiting. In such situations, a stroboscope is usually necessary to diagnose the voice problems and to rule out pathological conditions such as laryngeal tumors. If left untreated, the lesion can grow with time and result in a life-threatening airway condition. We also demonstrate our endoscopic technique in this report, and it has proven to be safe with no increased recurrence and much lower morbidity.

Inflammatory Myofibroblastic Tumor of the Epiglottis Excised with a Carbon Dioxide Laser: Case Report and Literature Review

“…5 No cases of laryngeal IMT metastasis have been reported to date. 4 Our patient underwent successful excision of an epiglottic IMT with a CO 2 laser, and she exhibited no evidence of recurrence after 6 months of follow-up.…”

“…1 Laryngeal occurrence is especially rare, as only about 40 cases have been reported in the English-language literature. 1,[3][4][5][6][7] The most common sites of laryngeal IMTs are the glottis (51% of cases), the subglottis (22.5%), and the anterior commissure (10%). 5 Reports of lesions involving the supraglottis are extremely rare; they include 1 case each originating in the aryepiglottic fold, vestibular fold, and vestibule.…”

“…1,2 Tumors involving the larynx are rare, as fewer than 40 cases have been reported in the English -language literature. 1,[3][4][5][6][7] To the best of our knowledge, we report the first published case of an IMT localized to the epiglottis.…”

Inflammatory Myofibroblastic Tumor of the Larynx: Report of a Rare Case and Literature Review

“…The tumor appears as a single mesenchymal pseudosarcoma [11] and is sometimes accompanied by fever, night sweats, weight loss and pain [1,2]. In the case of laryngeal I. M. Tumor, the original vocal cords are mainly affected and clinically manifested by voice hoarsness, dyspnoea, inhalation wheezing and stridor after effort [3,6,12].…”

Inflammatory myofibroblastic tumour mimicking a vocal cord polyp

“…IMT, also known as plasma cell granuloma, of the larynx was first described in 1986 1. These are rare tumours commonly found in the lungs, abdomen, retroperitoneum and the extremities, but rarely seen in the head and neck region.…”