Laryngeal oncocytic cystadenoma and sudden death

Abstract

An 86-year-old woman with Alzheimer disease collapsed in her nursing home and was not able to be resuscitated. At autopsy, the major findings were in the larynx where a pedunculated oncocytic cystadenoma had occluded the glottis. Oncocytic cysts or cystadenomas of the larynx are rare histologically benign lesions that account for only 0.1–1% of laryngeal lesions. While the usual presentation is of a sensation of a mass in the throat, hoarseness, or stridor, very occasionally, there may be acute airway compromise and sudden death. Oncocytic cystadenoma should, therefore, be included in the differential diagnosis of potentially lethal obstructive laryngeal lesions.

Oncocytic Papillary Cystadenoma: A Case of a Misdiagnosed Laryngeal Mass

“…If the mass expands through the thyrohyoid membrane, extralaryngeal manifestations, such as neck masses, have been described [ 2 ]. In a single case, OPC caused critical airway obstruction leading to death [ 5 ].…”

“…They have been reported to appear in the accessory tear glands, salivary glands, buccal mucosa, nasopharynx, oropharynx, and larynx [3,6]. Their presence in the larynx is extremely rare (less than 1% of all laryngeal tumors), accounting for approximately 150 cases in the literature [2,3,5,7,8]. As for the laryngeal subunits, they are most often encountered in the supraglottic region (74%), followed by the glottic (22%) and the subglottic region (4%) [2,3,5,[8][9][10].…”

“…Their presence in the larynx is extremely rare (less than 1% of all laryngeal tumors), accounting for approximately 150 cases in the literature [2,3,5,7,8]. As for the laryngeal subunits, they are most often encountered in the supraglottic region (74%), followed by the glottic (22%) and the subglottic region (4%) [2,3,5,[8][9][10]. This is due to the higher accumulation of ductal epithelial cells in the supraglottic area [2,3,7,8].…”

“…The epithelium of the OPCs consists of oncocytes, which are large and irregularly shaped cells with granular eosinophilic cytoplasm rich in mitochondria [2,5,[7][8][9]. The nuclei of the cells are hyperchromatic and the cytoplasm appears to be densely eosinophilic granular due to mitochondrial hyperplasia [2].…”

“…OPCs are most commonly encountered in areas where minor salivary glands are accumulated [1] while their presence in the laryngeal region is extremely rare [2,3]. Laryngeal OPCs were first described in 1897 by Koscher and Schaffer [3][4][5].…”