Smooth muscle tumours of the larynx

Abstract

Two cases of laryngeal smooth muscle tumours are reported: one a benign leiomyoma, the other a malignant leiomyosarcoma. These tumours may present diagnostic difficulties and immunocytochemistry is helpful in distinguishing smooth muscle tumours from other connective tissue neoplasms and spindle cell squamous carcinoma. Primary treatment in both cases should be surgical resection with small (T1, T2) malignant tumours suitable for partial laryngectomy. Postoperative radiotherapy may have a role in allowing a more limited surgical resection.

Leiomyosarcoma of the larynx

“…Men are more often affected than women. The majority of the laryngeal tumors have been situated in the supraglottic area, while only a few cases of tumor confined to the vocal fold have been reported [2,20,24]. Symptoms are not characteristic and, as in the present case, do not differ from those of other laryngeal malignancies.…”

“…Since blood vessels are the only structures with smooth muscle tissue in this anatomic region, it has been speculated that they develop from smooth muscle in the tunica media of vessel walls [24]. Some authors have also implicated dispersed undifferentiated mesenchymal tissue or suggest that they represent metastases of a primary tumor located elsewhere [20]. Ohashi et al [22] have traced them to myoepithelial cells in the submucosal glands of the respiratory epithelium, since their structure resembles that of smooth muscle cells.…”

“…The incidence of metastasis of lymph nodes in the neck is low and does not depend on tumor size. If sonography of cervical lymph nodes is negative, formal neck dissection is not necessary [20]. LMS of the larynx, like that in other sites, does not respond to radiotherapy or chemotherapy, although such treatment modalities can be applied as palliative measures in inoperable cases [15,20].…”

Leiomyosarcoma of larynx: A case report

“…This tumor usually occurs in the fi fth and sixth decades and has no sexual predilection. Smoking or alcohol abuse does not predispose to this tumor [6,7]. Symptoms of this tumor (hoarseness, stridor, dysphagia) donot differ from those of other laryngeal malignant tumors [5].…”

“…Three different types of leiomyosarcoma, the 'common' leiomyosarcoma, the vascular leiomyosarcoma and the epitheloid leiomyosarcoma , have been recognized [7]. Histologically, it is characterized by prominent interlacing bundles and fasicles of elongated spindle cells with elongated 'cigar-shaped' blunt-ended nuclei, prominent nucleoli and abundant eosinophilic cytoplasm [5].…”