Simultaneous double laryngeal tumours: a diagnostic and therapeutic challenge

Abstract

Leiomyosarcomas are soft tissue tumours that rarely occur in the larynx. This case report describes the presentation and management of a 77-year-old man referred to the otolaryngology clinic with hoarseness who was found to have a large supraglottic leiomyosarcoma after panendoscopy and biopsies. He subsequently underwent laryngectomy for treatment of this tumour but, unexpectedly, the histological analysis of the laryngectomy specimen revealed a second primary tumour in the larynx—a squamous cell carcinoma (SCC). The patient had further treatment with neck radiotherapy. Three years after treatment, there are no signs of recurrence of either tumour. This case report discusses the very few similar cases of leiomyosarcoma coexisting with SCC in the larynx, collating the evidence surrounding the treatment of this rare presentation.

Epstein–Barrvirus‐associated leiomyosarcoma of the larynx in an adult patient with human immunodeficiency virus infection: Case report and review of the literature

“…LLMS is uncommon; we identified 62 cases in the English‐language literature (Table 1). 1,3–55 Tangjaturonrasme found that the number of LLMS cases was increasing; four cases were reported from 1961 to 1970, compared to 21 cases from 2000 to 2010. This may be a result of advances in diagnostic techniques, including immunohistochemical techniques and electron microscopy 46 .…”

“…Although rhabdomyoblastic differentiation in the larynx is rare, it is common in other organs of the upper respiratory tract. Among 61 cases of LLMS, 5 (8.2%) had simultaneous LLMS and squamous cell carcinoma (SCC) 37,44,51,53,55 . One patient had been treated for laryngeal SCC 15 years prior.…”

“…It was first reported by Jackson and Jackson in 1939 2 . To the best of our knowledge, 62 cases of LLMS have been reported in the English‐language literature 1,3–55 …”

“…Factors predisposing to LLMS include radiation exposure, surgery, multiple basal cell carcinoma syndrome, Gardner syndrome, tuberous sclerosis, neurofibromatosis, Werner syndrome, retinoblastoma, Turcot syndrome, and Epstein–Barr virus (EBV) infection in immunosuppressed patients 1,3–55 …”

“…2 To the best of our knowledge, 62 cases of LLMS have been reported in the English‐language literature. 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 …”