Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome

Abstract

A 56-year-old female with a background of metastatic rectal adenocarcinoma presented with a subglottic mass causing biphasic stridor. Transoral laser microsurgery and the use of fibrin glue prevented the need for tracheostomy. Six months postoperatively there was no evidence of recurrence. Laryngeal metastasis of colorectal adenocarcinoma, although remarkably rare, is perhaps more prevalent than commonly perceived and the presence of laryngeal symptoms in a patient with colorectal adenocarcinoma should raise concern. This case is presented to aid physicians should they encounter a similar presentation of metastasis to the subglottis.

Metastatic sigmoid adenocarcinoma to the larynx: A case report and updated literature review

“… 9 , 10 , 11 In other cases reported, the local control of the disease was achieved by laser excision by Nd‐YAG laser and CO 2 laser. 5 , 12 A summary of laryngeal metastasis secondary to colorectal cancer is shown in Table 1 .…”

“…Puxeddu et al, Sano et al, and Ta et al managed their patients with a tracheostomy to protect the airway from local disease advancement 9–11 . In other cases reported, the local control of the disease was achieved by laser excision by Nd‐YAG laser and CO 2 laser 5,12 . A summary of laryngeal metastasis secondary to colorectal cancer is shown in Table 1.…”

“…Other cases are metastasis from the lung, bone, breast, thyroid, liver, and female genital tract. 3 , 5 …”

Subglottische Pathologien

“…In knapp 20 % der Fälle erfolgt dies in der subglottischen Region [81]. Als mögliche Primarien kommen hierfür Adenokarzinome der Niere [81], des Rektums [82,83], des Ovars [84] sowie der Prostata [85] in Frage.…”

Metastatic sigmoid adenocarcinoma to the larynx: a case report and updated literature review

“…(2-6) Metastatic laryngeal cancers represent less than 1% of all laryngeal malignancies, with Skin melanoma and Renal cell carcinoma being the most common primary cancers to metastasize to the larynx as reported by fertile et al in 1988, however, a recent review of the English literature showed that colorectal cancer metastasis to the larynx is the most common and compromise quarter of 41 cases. (3,5) Dysphonia is the term used to describe any impairment or alteration of the voice with hoarseness; primarily, it is due to vocal muscle irregular oscillation owing to underlying muscle tension or dysfunction, incomplete closure of glottis on vocalization, or pressure effect excreted on the vocal folds by mass or tumor. (4)…”