1
|
Cobanoglu HB, Koprucu ER. Non-squamous Cancers of the Larynx. Curr Oncol Rep 2024; 26:625-632. [PMID: 38668924 PMCID: PMC11168984 DOI: 10.1007/s11912-024-01535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE OF REVIEW Although non-squamous tumors of the larynx are really rare, they may not always be viewed from the same perspective in the multidisciplinary treatment approach once the diagnosis is made. In this review, non-squamous tumors of the larynx and current approaches in treatment will be discussed. RECENT FINDINGS When the studies and meta-analyses presented in the last 5 years are evaluated, it is seen that these tumors usually show non-specific symptoms. Due to their submucosal location, the stage of the disease at the time of diagnosis is often advanced. In the literature, treatment may vary in these particular cases. The majority of non-squamous tumors of the larynx includes minor salivary gland tumors, neuroendocrine carcinomas, sarcomas, cartilage tumors, and malignant melanomas. Once treating a patient with these diagnoses, it should be kept in mind that the histopathological subtype is almost as important as the stage of the tumor.
Collapse
Affiliation(s)
- H Bengu Cobanoglu
- Faculty of Medicine, Department of Otorhinolaryngology Head & Neck Surgery, Karadeniz Technical University, Trabzon, Turkey.
| | - Erdal Rahman Koprucu
- Faculty of Medicine, Department of Otorhinolaryngology Head & Neck Surgery, Karadeniz Technical University, Trabzon, Turkey
| |
Collapse
|
2
|
Baudouin R, Von Tokarski F, Rigal T, Crambert A, Hertig A, Hans S. Immunosuppressive protocols after laryngeal transplantation: a systematic review. Acta Otolaryngol 2024; 144:243-249. [PMID: 38662869 DOI: 10.1080/00016489.2024.2339341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/28/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUNDS Larynx transplantation has been successfully performed four times, in 1998, 2010, 2015 and 2023 remained the ultimate goal of voice, feeding and breathing rehabilitation. OBJECTIVE Immunosuppressive protocols used during the previous successful larynx allotransplantation are detailed. MATERIAL AND METHODS A systematic review of the literature on PUBMED/Medline, Cochrane and Embase was conducted. Articles relating to actual human larynx transplantations were included. RESULTS Bibliography search gathered N = 10 publications related to the performance and follow-up of human laryngeal transplantations. N = 8 publications were included corresponding to N = 3 actual human larynx transplantations performed in 1998 and 2010 in the USA and in 2015 in Poland. Immunosuppression protocols, induction and maintenance strategies, rejection monitoring and history of all the three previous laryngeal grafts were detailed. CONCLUSIONS Beyond the surgical prowess, larynx transplantation is feasible and associated with a reasonably successful outcome when compared to other solid organ transplants. Immunosuppressive regimen protocols and technologies for the monitoring of the organ viability have evolved. SIGNIFICANCE The reevaluation of this surgical option serves as the reminder of the critical necessity to implement a meticulous immunosuppression protocol when transplanting this inherently immunogenic composite organ, the larynx.
Collapse
Affiliation(s)
- Robin Baudouin
- Department of Otolaryngology‑Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France
| | - Florent Von Tokarski
- Department of Nephrology, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France
| | - Tiffany Rigal
- Department of Otolaryngology‑Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France
| | - Anna Crambert
- Department of ENT Head and Neck Surgery, Percy Military Training Hospital, Clamart, France
| | - Alexandre Hertig
- Department of Nephrology, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France
| | - Stéphane Hans
- Department of Otolaryngology‑Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France
| |
Collapse
|
3
|
Gazda P, Baujat B, Sarini J, Gomez-Brouchet A, Philouze P, Moya-Plana A, Malard O, Fakhry N, De Mones Del Pujol E, Garrel R, Page C, Mouawad F, Vaz E, Evrard D, Bach C, Dufour X, Lelonge Y, Schultz P, Mauvais O, Brenet E, Vergez S, Atallah S. Functional or radical surgical treatment of laryngeal chondrosarcoma, analysis of survival and prognostic factors: A REFCOR and NetSarc-ResOs multicenter study of 74 cases. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107315. [PMID: 38219696 DOI: 10.1016/j.ejso.2023.107315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Laryngeal chondrosarcoma (LCS) is a rare tumor of slow evolution whose treatment is poorly codified. For a long time, a radical treatment by total laryngectomy (TL) was proposed. More recent studies tend to propose a conservative surgical approach of the larynx. The objective of this study was to compare the overall survival (OS) of total laryngectomized patients (TL+) versus non-laryngectomized patients (TL-). The secondary objectives were to analyse the reoperation free survival (RFS), the total laryngectomy free survival (TLFS) and to identify the preoperative factors leading surgeons to propose TL. MATERIALS AND METHODS A retrospective analysis of prospectively collected incident cases from the REFCOR and NetSarc-ResOs multicenter databases between March 1997 and June 2021 was conducted. A propensity score matching analysis was performed to compare the OS of TL+ and TL-patients. RESULTS 74 patients were included. After propensity score, the 5-year OS of TL+ and TL-patients was comparable (100 %, p = 1). The 5-year RFS rate was 69.2 % (95 % CI [57.5-83.4]) and the 5-year TLFS was 61.7 % (95 % CI [50.4-75.5]). Cricoid involvement greater than 50 % (HR 3.58; IC 95 % [1.61-7.92] p < 0.001), an ASA score of 3 or 4 (HR 5.07; IC 95 % [1.64-15.67] p = 0.009) and involvement of several cartilages (HR 5.26; IC 95 % [1.17-23.6] p = 0.04) are prognostic factors for TL. Dyspnea caused by the tumour is a prognostic factor for reoperation (HR 2.59; IC 95 % [1.04-6.45] p = 0.03). CONCLUSION These results demonstrate that conservative treatment should be considered as first-line treatment for laryngeal chondrosarcoma.
Collapse
Affiliation(s)
- Pierre Gazda
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France; Department of ENT-Head and Neck Surgery, CHU Larrey Toulouse, 24 Chemin de Pouvourville, 31400 Toulouse, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la Chine 75020, Paris, France
| | - Jérôme Sarini
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France
| | - Anne Gomez-Brouchet
- Department of Pathology and Cytopathology, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France
| | - Pierre Philouze
- Department of ENT-Head and Neck Surgery, Hospices Civils de Lyon, Lyon-Nord University Hospital, 103 Grande Rue de La Croix Rousse, 69000, Lyon, France
| | - Antoine Moya-Plana
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805, Villejuif, France
| | - Olivier Malard
- Department of ENT-Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000, Nantes, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915, Marseille, France
| | - Erwan De Mones Del Pujol
- Department of ENT-Head and Neck Surgery, University Hospital of Bordeaux, 12 rue Dubernat 33404 Talence France
| | - Renaud Garrel
- Department of ENT-Head and Neck Surgery, University Hospital of Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Cyril Page
- Department of ENT-Head and Neck Surgery, University Hospital of Amiens, 3 Rue des Louvels, 80000 Amiens, France
| | - Francois Mouawad
- Department of ENT-Head and Neck Surgery, CANTHER "Cancer heterogeneity, Plasticity and Resistance to Therapies", UMR9020 - U1277 Inserm - Lille University - University Hospital of Lille - Oscar Lambret Center, 59037 Lille Cedex, France
| | - Emmanuelle Vaz
- Department of Pathology and Cytopathology, Tenon Hospital, APHP, 4 rue de la Chine, 75020, Paris, France
| | - Diane Evrard
- APHP, Department of ENT-Head and Neck Surgery, Bichat Hospital, 46 rue Henri-Huchard, 75018 Paris, France
| | - Christine Bach
- Departement of ENT-Head and Neck Surgery, Clinique Chirurgicale du Val D'Or, 14 Rue Pasteur, 92210 Saint-Cloud, France
| | - Xavier Dufour
- Department of ENT-Head and Neck Surgery, University Hospital of Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France
| | - Yann Lelonge
- Department of ENT-Head and Neck Surgery, University Hospital of Saint-Etienne, Av. Albert Raimond, Saint-Etienne, France
| | - Philippe Schultz
- Department of ENT-Head and Neck Surgery, University Hospital of Strasbourg, 67000, Strasbourg, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, University Hospital of Besançon, France, 25000, Besançon, France
| | - Esteban Brenet
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100, Reims, France
| | - Sébastien Vergez
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France; Department of ENT-Head and Neck Surgery, CHU Larrey Toulouse, 24 Chemin de Pouvourville, 31400 Toulouse, France.
| | - Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la Chine 75020, Paris, France
| |
Collapse
|
4
|
Schleich M, Laccourreye L, Marianowski R, Dufour X, Babin E, Bastit V, Marie JP, Badoual C, Philouze P, Espitalier F, Du Bouexic De Pinieux G, Moriniere S. Treatment strategy in laryngeal chondrosarcoma: a multicenter study of 43 cases. Eur Arch Otorhinolaryngol 2024; 281:883-890. [PMID: 37752251 DOI: 10.1007/s00405-023-08248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE Laryngeal chondrosarcoma is a rare tumor that mostly affects the cricoid cartilage. The aim of this study was to compare outcomes between the various treatments of this pathology as there are no official guidelines for this pathology. METHODS A retrospective analysis of the pathology database of nine French tertiary care centers was conducted. Outcomes of patients treated by total laryngectomy were compared with those treated by more conservative approaches (endoscopic debulking, median thyrotomy, partial laryngectomy). Two Kaplan-Meier survival analyses were performed: one to assess the overall survival rate and the other to assess laryngeal preservation over time. RESULTS A total of 43 patients were enrolled: 12 with total laryngectomy as the initial treatment, and 31 who initially underwent laryngeal-preserving treatment. With conservative treatment, laryngeal function was preserved in 96% and 75% of patients at 1 and 5 years, respectively. Conservative treatment did not reduce the overall survival rate. CONCLUSION These results suggest that laryngeal preservation should be considered as the initial treatment in cases of laryngeal chondrosarcoma.
Collapse
Affiliation(s)
- Marianne Schleich
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Tours, 2 Boulevard Tonnellé, 37000, Tours, France.
| | - Laurent Laccourreye
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Angers, Angers, France
| | - Remi Marianowski
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Brest, Brest, France
| | - Xavier Dufour
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
| | - Emmanuel Babin
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Caen, Caen, France
| | - Vianney Bastit
- Department of Otolaryngology-Head and Neck Surgery, François Baclesse Center, Caen, France
| | - Jean Paul Marie
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France
| | - Cécile Badoual
- Department of Pathology, European Hospital of Georges Pompidou, Paris, France
| | - Pierre Philouze
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse University Hospital, Lyons, France
| | - Florent Espitalier
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Nantes, Nantes, France
| | | | - Sylvain Moriniere
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Tours, 2 Boulevard Tonnellé, 37000, Tours, France
| |
Collapse
|
5
|
Yücel L, Yücel KB, Başak H, Beton S, Büyükatalay ZÇ. Survival Outcomes of Non-squamous Cell Carcinoma and Rare Squamous Cell Carcinoma Variants of the Larynx. Indian J Otolaryngol Head Neck Surg 2023; 75:3161-3175. [PMID: 37974887 PMCID: PMC10645804 DOI: 10.1007/s12070-023-03934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 11/19/2023] Open
Abstract
The literature focuses primarily on laryngeal differentiated squamous cell carcinoma (SCC), and only a limited number of studies have evaluated the outcomes of rare variants of SCC (vSCC) and non-SCC malignancies (nSCC). To our knowledge, this is the first study to compare the survival outcomes of these two groups. We retrospectively reviewed the records of 816 patients who underwent laryngeal surgery from January 2010 to November 2022. Forty-nine (6.2%) were identified as having unusual larynx malignancies and categorized in the nSCC or vSCC groups. The patients' clinicopathological features were then recorded. We compared the two groups' overall survival (OS) and recurrence-free survival (RFS) outcomes. Thirty-three (4.2%) patients had vSCC, and 16 (2%) had nSCC. Forty-two (85.7%) were male, and the mean age was 58.57 years. The median follow-up time was 69 months. The 5-year OS rate was 71.4% in the nSCC group vs. 87.9% in the vSCC group (p = .055). Only surgical margin (HR: 4.68; 95% CI:1.13-19.37, p = .033) was an independent prognostic factor for OS in the multivariable analysis. The 5-year RFS rate was 50% for the nSCC group compared to 90.9% for the vSCC group (p < .001). In the multivariable analysis, surgical margin positivity (HR: 21.0, 95% CI 3.97-98.1, p < .001), and lymphovascular invasion (HR: 0.043, 95% CI 0.005-0.357, p = .004) were independent prognostic factors for RFS. Although OS did not show a statistical difference, nSCC malignancies of the larynx demonstrated worse OS and RFS outcomes than vSCC malignancies. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03934-8.
Collapse
Affiliation(s)
- Levent Yücel
- Department of Otorhinolaryngology, University of Health Sciences, Gülhane Training and Research Hospital, General Dr. Tevfik Sağlam Street, No:1, Etlik/Ankara, 06010 Turkey
- Department of Otorhinolaryngology, Faculty of Medicine, University of Ankara, Ankara, Turkey
| | - Kadriye Bir Yücel
- Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hazan Başak
- Department of Otorhinolaryngology, Faculty of Medicine, University of Ankara, Ankara, Turkey
| | - Süha Beton
- Department of Otorhinolaryngology, Faculty of Medicine, University of Ankara, Ankara, Turkey
| | | |
Collapse
|
6
|
Piazza C, Lancini D, Zigliani G, Del Bon F, Tomasoni M, Montenegro C, Rampinelli V, Mattavelli D. Hemicricoidectomy with modified rotational thyro-crico-tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:382-389. [PMID: 37814978 PMCID: PMC10773548 DOI: 10.14639/0392-100x-n2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 10/11/2023]
Abstract
Objective The aim of the present study is to describe our novel surgical technique of hemicricoidectomy and reconstruction with modified rotational thyro-crico-tracheal anastomosis for the treatment of non-squamous cell subglottic tumours. The procedure has been defined as Type E crico-tracheal resection and anastomosis (CTRA) following the University of Brescia (C)TRA classification introduced elsewhere. Methods A detailed anatomical step-by-step dissection was reproduced and illustrated on a cadaveric laryngo-tracheal specimen. Moreover, oncological and functional outcomes of the first 5 patients who underwent Type E CTRA at our Institution between October 2016 and September 2022 are described. Results Three patients underwent Type E CTRA for cricoid chondrosarcoma (CS) and 2 patients for subglottic adenoid cystic carcinoma (ACC). No post-operative complication was reported. All patients maintained intact oral intake and an intelligible voice at discharge. All but one patient with obstructive sleep apnoea hypopnea syndrome and lung comorbidity were successfully decannulated before discharge. At the last follow-up (April 2023), one patient experienced local recurrence of CS that was still amenable to conservative treatment by transoral debulking, while the remaining patients were free of disease. Conclusions With the proper indications, Type E CTRA is a feasible and effective conservative surgical technique for selected non-squamous cell subglottic tumours.
Collapse
Affiliation(s)
- Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gabriele Zigliani
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Francesca Del Bon
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Montenegro
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| |
Collapse
|
7
|
Wong E, Smith M, Buchanan MA, Kudpaje A, Williamson A, Hedge PS, Hazan D, Idaire J, Smith MC, Sritharan N, Palme C, Riffat F. Smell-related quality of life changes after total laryngectomy: a multi-centre study. Eur Arch Otorhinolaryngol 2023; 280:3861-3866. [PMID: 37115324 PMCID: PMC10313529 DOI: 10.1007/s00405-023-07976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE A total laryngectomy creates an alternate airway for gas exchange that bypasses the upper aerodigestive tract. The subsequent reduction in nasal airflow, and therefore, reduction in deposition of particles to the olfactory neuroepithelium leads to hyposmia or anosmia. The aim of this study was to assess the quality of life impairment conferred by anosmia following laryngectomy and identify any specific patient-related risk factors that are associated with poorer outcomes. METHODS Consecutive patients with a total laryngectomy presenting for review at three tertiary head and neck services (in Australia, the United Kingdom and India) over a 12-month period were recruited. Patient demographic and clinical data were collected, and each subject completed the validated assessment of self-reported olfactory functioning and olfaction-related quality of life questionnaire (ASOF). Dichotomous comparisons were performed using the student's unpaired t-test for continuous variables (SRP), a chi-squared test for categorical variables, and a Kendall's tau-b for ordinal variables (SOC) to assess for a correlation with poorer questionnaire scores. RESULTS A total of 66 laryngectomees (13.4% female; age 65.7 ± 8.6 years) were included in the study. The mean SRP score of the cohort was found to be 15.6 ± 7.4, while the mean ORQ score was noted to be 16.4 ± 8.1. No other specific risk factors associated with poorer quality of life were identified. CONCLUSION A significant quality of life detriment from hyposmia is conferred following laryngectomy. Further research to assess treatment options and the patient population that would best benefit from these interventions is required.
Collapse
Affiliation(s)
- Eugene Wong
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW, 2006, Australia.
- Department of Surgery, School of Medicine and Health Sciences, University of Sydney, Camperdown, Australia.
| | - Murray Smith
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW, 2006, Australia
| | | | - Akshay Kudpaje
- Department of Head and Neck Surgical Oncology, Cytecare Cancer Hospitals, Bangalore, India
| | - Andrew Williamson
- Department of ENT Surgery, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Prasanna Suresh Hedge
- Department of Head and Neck Surgical Oncology, Cytecare Cancer Hospitals, Bangalore, India
| | - Daniel Hazan
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Jordan Idaire
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Mark C Smith
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW, 2006, Australia
- Department of Surgery, School of Medicine and Health Sciences, University of Sydney, Camperdown, Australia
- Chris O'Brien Lifehouse, Camperdown, NSW, 2006, Australia
- Department of Otolaryngology, Head and Neck Surgery, Macquarie University Hospital, Macquarie Park, Australia
| | - Niranjan Sritharan
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW, 2006, Australia
- Department of Surgery, School of Medicine and Health Sciences, University of Sydney, Camperdown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Carsten Palme
- Department of Surgery, School of Medicine and Health Sciences, University of Sydney, Camperdown, Australia
- Chris O'Brien Lifehouse, Camperdown, NSW, 2006, Australia
| | - Faruque Riffat
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Camperdown, NSW, 2006, Australia
- Department of Surgery, School of Medicine and Health Sciences, University of Sydney, Camperdown, Australia
- Chris O'Brien Lifehouse, Camperdown, NSW, 2006, Australia
- Department of Otolaryngology, Head and Neck Surgery, Macquarie University Hospital, Macquarie Park, Australia
| |
Collapse
|
8
|
O'Neill RJ, Hintze J, Sharifah A, Garry S, Woods G, Noone A, Barrett HL, Young O, Mamdouh S, Shine N, Timon C, Kinsella J, Sheahan P, Lennon P, O'Neill JP. Non-conventional laryngeal malignancies: a multicentre review of management and outcomes. Eur Arch Otorhinolaryngol 2023; 280:3383-3392. [PMID: 37005958 DOI: 10.1007/s00405-023-07937-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE Non-conventional laryngeal malignancies (NSCC) often have limited published data to guide management despite individual histopathological subtypes often exhibiting heterogeneous behaviour, characteristics, and treatment responses compared to laryngeal squamous cell carcinoma (SCC). This study aimed to compare oncological outcomes with SCC, specifically disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS). Secondary objectives were to compare treatment differences and perform a state of the art review. METHODS This was a multicentre retrospective cohort study at four tertiary head and neck centres. Survival outcomes between NSCC and SCC patients were analysed with Kaplan-Meier curves and compared by log rank testing. Univariate Cox regression analysis was performed to predict survival by histopathological subgroup, T-stage, N-stage and M-stage. RESULTS There were no significant differences in 3-year DFS (p = 0.499), DSS (p = 0.329), OS (p = 0.360) or Kaplan Meier survival curves (DSS/OS) between SCC and overall NSCC groups. However, univariate Cox regression analysis identified "rare" histopathologies (mostly small cell carcinoma) to be predictive of less favourable OS (p = 0.035) but this result was not observed for other NSCC histopathological subgroups. N-stage (p = 0.027) and M-stage (p = 0.048) also predicted OS for NSCC malignancies. Significant differences in treatment modalities were identified with treatment of NSCC typically involving surgical resection and SCC often managed non-surgically (e.g., primary radiotherapy). CONCLUSIONS Although overall NSCC is managed differently compared to SCC, there do not appear to be differences in survival outcomes between these groups. N-stage and M-stage appear to be more predictive of OS than histopathology than many NSCC subtypes.
Collapse
Affiliation(s)
- Rory J O'Neill
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.
- Royal College of Surgeons, Dublin, Ireland.
| | - Justin Hintze
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons, Dublin, Ireland
| | - Adrinda Sharifah
- Department of Otorhinolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland
| | - Stephen Garry
- Royal College of Surgeons, Dublin, Ireland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - Graham Woods
- Department of Histopathology, Beaumont Hospital, Dublin, Ireland
| | - Anthony Noone
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Helen L Barrett
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Orla Young
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - Sherif Mamdouh
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons, Dublin, Ireland
| | - Neville Shine
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Conrad Timon
- Department of Otorhinolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
| | - John Kinsella
- Department of Otorhinolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland
| | - Patrick Sheahan
- Department of Otorhinolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland
- University College Cork, Cork, Ireland
| | - Paul Lennon
- Department of Otorhinolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland
| | - James Paul O'Neill
- Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons, Dublin, Ireland
| |
Collapse
|
9
|
MacNeil SD. Non-squamous Laryngeal Cancer. Otolaryngol Clin North Am 2023; 56:345-359. [PMID: 37030947 DOI: 10.1016/j.otc.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
The pathology of non-squamous carcinoma of the larynx is broad and there is a wide differential diagnosis. The most common presenting symptoms for laryngeal malignancies, both squamous and non-squamous, are hoarseness and dyspnea. Presentation with persistent or worsening symptoms and a submucosal lesion should raise suspicion for a non-squamous malignancy of the larynx. Accurate histology determines the most appropriate treatment and has an impact on prognosis.
Collapse
|
10
|
Kinsella A, Corbett M, Hacking S, Lang J. Chondrosarcoma of the thyroid cartilage: surgical management of a rare case. BMJ Case Rep 2023; 16:e251654. [PMID: 36653050 PMCID: PMC9853151 DOI: 10.1136/bcr-2022-251654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Laryngeal malignancy encompasses about 1% of all cancers. Chondrosarcoma in the head and neck region represents about 0.1% of head and neck malignancies. Typical presenting symptoms relate to the anatomical location of these tumours and include dysphonia, inspiratory stridor, dysphagia, odynophagia or a neck mass. Benign and malignant cartilaginous cancers of the larynx have been described, and preoperative diagnosis can be difficult. Our report highlights the surgical management of a male patient in his 50s with chondrosarcoma of the thyroid cartilage.
Collapse
Affiliation(s)
- Anna Kinsella
- Department of Otolaryngology, Galway University Hospital, Galway, Ireland
| | - Mel Corbett
- Department of Otolaryngology, Galway University Hospital, Galway, Ireland
| | - Sean Hacking
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - John Lang
- Department of Otolaryngology, Galway University Hospital, Galway, Ireland
| |
Collapse
|
11
|
Álvarez-Calderón-Iglesias O, Pérez-Sayáns M, Hurtado-Ruzza R, Lorenzo-Pouso A, Chamorro-Petronacci C. Survival outcomes in laryngeal chondrosarcoma: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:502-515. [PMID: 36654516 PMCID: PMC9853110 DOI: 10.14639/0392-100x-n1912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 09/27/2022] [Indexed: 01/18/2023]
Abstract
Laryngeal chondrosarcomas (LCS) are rare lesions that behave as locally aggressive tumours, producing symptoms such as dysphonia, dyspnoea, dysphagia and hoarseness. Different approaches for the treatment of LCS have been described in the literature. The main purpose of this investigation was to find all cases of LCS published to date and analyse management data and survival outcomes. In December 2020, a systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Provider Enrollment, Chain, and Ownership System (PECOS) method including articles published up to this date on different aspects of LCS. The search included the terms larynx, laryngeal, chondrosarcoma. A total of 148 articles were included in this systematic review describing 381 cases of LCS. Dyspnoea was the most reported symptom followed by hoarseness and neck mass sensation. Cricoid cartilage was the most usual location. Survival rate was influenced by both surgical technique (log-rank = 11.7; p = 0.008) and the degree of tumour histologic differentiation (log-rank = 18.3; p = 0.003).
Collapse
Affiliation(s)
- Oscar Álvarez-Calderón-Iglesias
- Department of Health Sciences; Faculty of Nursing and Podiatry; Research, Health and Podiatry Group - Universidade da Coruña; HM Hospitals Research Foundation, Madrid, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Rafael Hurtado-Ruzza
- Department of Otorhinolaryngology, Complexo Hospitalario Universitario de Ourense, Province of Ourense, Spain; Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
| | - Alejandro Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Cintia Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain,Correspondence Cintia Micaela Chamorro Petronacci C/ entrerrios S/N, CP: 15706, Santiago de Compostela, Spain Tel.: +34 651011815 E-mail:
| |
Collapse
|
12
|
Baishya P, Jeladharan R, Usmani S, Durgapal P. The Rare Horse behind the Hoarseness of Voice-Chondrosarcoma of Larynx. Indian J Otolaryngol Head Neck Surg 2022; 74:5091-5093. [PMID: 36742885 PMCID: PMC9895187 DOI: 10.1007/s12070-021-02778-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/25/2021] [Indexed: 02/07/2023] Open
Abstract
Laryngeal chondrosarcomas are rare tumors. They usually clinically present late as they are slow growing tumors. We reported a case of laryngeal chondrosarcoma in a middle-aged male present with hoarseness of voice along with stridor. The tumor was located in subglottis with destruction of cricoid cartilage. The histopathological evaluation is particularly important as diagnosis and grading needs strict follow up of criteria.
Collapse
Affiliation(s)
- Pakesh Baishya
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, AIIMS Rishikesh, Rishikesh, Uttarakhand 249203 India
| | - Reshma Jeladharan
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, AIIMS Rishikesh, Rishikesh, Uttarakhand 249203 India
| | - Shahab Usmani
- Department of Head and neck Oncosurgery, All India Institute of Medical Sciences, AIIMS Rishikesh, Rishikesh, Uttarakhand 249203 India
| | - Prashant Durgapal
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, AIIMS Rishikesh, Rishikesh, Uttarakhand 249203 India
| |
Collapse
|
13
|
Gandhi S, Ganesuni D, Desai SM, Bhatta S, Ghanpur GBKAD. Low Grade Laryngeal Chondrosarcoma: Clinical Presentation, Management and Short Term Outcome. Indian J Otolaryngol Head Neck Surg 2022; 74:1893-1895. [PMID: 36452648 PMCID: PMC9701917 DOI: 10.1007/s12070-020-01891-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/02/2020] [Indexed: 11/25/2022] Open
Abstract
Low grade laryngeal chondrosarcomas are rare, slow growing tumors. Surgical removal of the tumor along with preservation of laryngeal function is the preferred modality of treatment. We report a case of a large low grade chondrosarcoma removed by transoral CO2 LASER surgery which had avoided an open surgery.
Collapse
Affiliation(s)
- Sachin Gandhi
- Department of Laryngology, Deenanath Mangeshkar Hospital, Pune, India
| | | | | | - Subash Bhatta
- Department of Laryngology, Deenanath Mangeshkar Hospital, Pune, India
| | | |
Collapse
|
14
|
Bielack SS. Systemic treatment for primary malignant sarcomas arising in craniofacial bones. Front Oncol 2022; 12:966073. [PMID: 36158667 PMCID: PMC9492845 DOI: 10.3389/fonc.2022.966073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/22/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Craniofacial bones may be the site of origin of various sarcomas. We review the various malignancies affecting this region of the body and attempt to put systemic treatment approaches into perspective. Material and methods Non-systematic literature review Results Conventional types of osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most frequent bone sarcomas occurring in craniofacial region, but variants may occur. The tumors’ biologies and the resulting treatment strategies vary distinctly. As a general rule, local control remains paramount regardless of histology. The efficacy of antineoplastic chemotherapy varies by type of malignancy. It is clearly indicated in Ewing sarcoma and related tumors, potentially of benefit in high-grade osteosarcoma, undifferentiated pleomorphic sarcoma, dedifferentiated and mesenchymal chondrosarcoma, and of no proven benefit in the others. Conclusions Various histologies demand various and distinct treatment approaches, with local control remaining paramount in all. The efficacy of systemic treatments varies by type of tumor. Prospective trials would help in all of these to better define systemic treatment strategies.
Collapse
Affiliation(s)
- Stefan S. Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent and Women’s Medicine, Stuttgart Cancer Center, Klinikum Stuttgart–Olgahospital, Stuttgart, Germany
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany
- *Correspondence: Stefan S. Bielack,
| |
Collapse
|
15
|
Alessandrini L, Franz L, Marioni G. In reference to Non-Squamous Cell Malignancies of the Larynx. Laryngoscope 2022; 132:E34. [PMID: 35856313 DOI: 10.1002/lary.30302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Lara Alessandrini
- Surgical Pathology Unit, Department of Medicine DIMED, University of Padova, Padua, Italy
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padua, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padua, Italy
| |
Collapse
|
16
|
Mirza N, Veeraballi S, Rayad MN, Kamal F, Shaaban H, Lee D, Savopoulos A. A Rare Case of Aggressive Metastatic Laryngeal Chondrosarcoma Presenting as Bilateral Necrotizing Pneumonia. EAR, NOSE & THROAT JOURNAL 2022:1455613221100005. [PMID: 35635129 DOI: 10.1177/01455613221100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Laryngeal chondrosarcomas are rare tumors that account for only 0.2% of malignant tumors of the larynx. Approximately 80% of these tumors are low grade and well differentiated and are associated with a good long-term prognosis. Herein, we report a case of a 77-year-old male presenting with acute hypoxic respiratory failure that required intubation and mechanical ventilation. Chest CT showed multiple pulmonary nodules and cavities. He then required a tracheostomy, and a soft tissue mass in the subglottic mass was discovered. A laryngoscopy-guided excisional biopsy of the mass was performed. Histopathological examination confirmed the diagnosis of laryngeal chondrosarcoma. Clinicians should consider metastatic laryngeal chondrosarcoma as a differential diagnosis for lung cavities. Overall, we believe this to be the first case of aggressive laryngeal chondrosarcoma with mediastinal and pulmonary metastasis mimicking necrotizing pneumonia.
Collapse
Affiliation(s)
- Noreen Mirza
- Internal Medicine, Saint Michael's Medical Center, Newark, NJ, USA
| | | | | | - Fatima Kamal
- Medical Education, Saint Michael's Medical Center, Newark, NJ, USA
| | - Hamid Shaaban
- Hematology Oncology, 22423Saint Michael's Medical Center, Newark, NJ, USA
| | - Derek Lee
- Otolaryngology/ENT, Saint Michael's Medical Center, Newark, NJ, USA
| | - Andreas Savopoulos
- Hematology Oncology, 22423Saint Michael's Medical Center, Newark, NJ, USA
| |
Collapse
|
17
|
Mahase SS, Singh B, Wong RJ, Ganly I, Boyle JO, Patel SG, Lee NY. Primary chondrosarcomas of the larynx treated with proton radiotherapy: A single institutional experience. Cancer Rep (Hoboken) 2022; 5:e1621. [PMID: 35537940 PMCID: PMC9458497 DOI: 10.1002/cnr2.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/22/2022] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Primary laryngeal chondrosarcomas are rare entities whose excellent survival rates following resection promote conservative surgical approaches to maintain quality of life without compromising outcomes. There are excellent outcomes in skull base chondrosarcomas treated with maximal safe resection and post‐operative proton therapy. Extrapolating from these findings, we report our institutional experience treating symptomatic or growing laryngeal chondrosarcomas using proton beam therapy. Cases Demographic information, clinical characteristics, treatment details, and follow‐up data were collected and summarized. Patients were monitored with serial imaging and examination. Stable disease was defined as no progression of disease on imaging. Two patients underwent subtotal resections followed by post‐operative radiotherapy, while two patients received definitive radiotherapy. All patients are currently alive with stable disease at their last follow‐up. Conclusion This case series provides initial evidence for excellent outcomes with maximal safe surgical resection followed by proton beam therapy for patients with symptomatic or growing laryngeal chondrosarcomas. Larger studies are warranted to determine the optimal therapeutic approach.
Collapse
Affiliation(s)
- Sean S Mahase
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Bhuvanesh Singh
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard J Wong
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jay O Boyle
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
18
|
Intubation with a Tritube to avoid peri-operative tracheostomy in open airway surgery. The Journal of Laryngology & Otology 2022; 136:1333-1335. [DOI: 10.1017/s002221512200024x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background
This paper reports a case of chondrosarcoma deriving from the left arytenoid cartilage that was resected via an anterior laryngofissure using the Tritube in situ, thus eliminating the need for a (temporary) tracheostomy.
Case report
A 49-year-old male with a chondrosarcoma deriving from the left arytenoid was treated with local resection of the tumour through an anterior laryngofissure. The intralaryngeal lumen was too small for a normal endotracheal tube. Using the Tritube (outer diameter, 4.4 mm), the patient could be intubated and ventilated adequately during the procedure. The Tritube did not obstruct the surgical view during the procedure.
Conclusion
The Tritube can be used for intubation and ventilation even in patients with a very narrow airway lumen, and does not obstruct the field of view during open laryngeal surgery, thereby avoiding the need for peri-operative tracheostomy.
Collapse
|
19
|
Baba A, Kurokawa R, Kurokawa M, Ota Y, Lobo R, Srinivasan A. Imaging features of laryngeal chondrosarcomas: A case series and systematic review. J Neuroimaging 2022; 32:213-222. [PMID: 35019171 DOI: 10.1111/jon.12963] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND PURPOSE To comprehensively summarize the characteristics of radiological findings of laryngeal conventional chondrosarcomas. METHODS We included patients with pathologically proven laryngeal conventional chondrosarcomas with CT and /or MRI, including 41 cases from 31 publications recruited after a systematic review and 14 cases from our institution. Two board-certified radiologists reviewed and evaluated all the radiological images. The relationship between pathological grade and radiological findings was analyzed. RESULTS The median long diameter of the lesion was 3.1 cm (range, 1.5-8.5 cm). The most common location was the cricoid (74.5%), followed by the thyroid (12.7%), cricoid and thyroid (7.3%), and arytenoid (5.5%). All lesions showed well-defined margins. Cortical defect/expansion (98.0%), internal low density (89.6%), and calcification (95.8%) with homogeneous and scarce contrast enhancement on contrast-enhanced CT (85.3%) were frequently observed. All cases showed high signal on T2-weighted imaging, low signal on T1-weighted imaging (T1WI), and heterogeneous and mild contrast enhancement on postcontrast T1WI. No significant differences were found between the pathological grades and radiological findings. CONCLUSIONS In our summary of comprehensive CT and MRI findings of laryngeal conventional chondrosarcomas, we found that the knowledge of these radiological features may facilitate prompt diagnosis and appropriate management.
Collapse
Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Remy Lobo
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
20
|
Wangaryattawanich P, Agarwal M, Rath T. Imaging features of cartilaginous tumors of the head and neck. J Clin Imaging Sci 2022; 11:66. [PMID: 34992942 PMCID: PMC8720426 DOI: 10.25259/jcis_186_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
There is a wide spectrum of head and neck cartilaginous lesions which include both neoplastic and nonneoplastic processes. Cartilaginous tumors of the head and neck are uncommon, posing a diagnostic challenge. Benign cartilaginous tumors that may occur in the head and neck include chondroma, chondroblastoma, chondromyxoid fibroma, osteochondroma, and synovial chondromatosis. Chondromesenchymal hamartoma is a rare non-neoplastic cartilaginous lesion that is included for the 1first time in the new WHO classification and radiologically can mimic a tumor. Malignant cartilaginous tumors include chondrosarcoma and chondroid variant of chordoma. Characteristic tumor locations, internal chondroid matrix calcification, and typical T2 hyperintense signal secondary to high-water content within the extracellular matrix of the hyaline cartilage are useful imaging features that narrow the differential diagnosis and help in diagnosing these diseases. This article presents a narrative review of the anatomy of the head and neck cartilaginous structures, discusses the current knowledge and imaging spectrum of benign and malignant cartilaginous tumors and tumor-like lesions of the head and neck.
Collapse
Affiliation(s)
- Pattana Wangaryattawanich
- Department of Radiology, Division of Neuroradiology, University of Washington School of Medicine, Seattle, Washington, United States
| | - Mohit Agarwal
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Tanya Rath
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States
| |
Collapse
|
21
|
Rotsides JM, Patel E, Oliver JR, Moses LE, Jacobson AS, Hu KS, Vaezi A, Tam M, Givi B. Non-Squamous Cell Malignancies of the Larynx. Laryngoscope 2022; 132:1771-1777. [PMID: 34994977 DOI: 10.1002/lary.30007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/05/2021] [Accepted: 12/27/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES/HYPOTHESIS Non-squamous cell carcinoma (SCC) malignancies are rare, but well described laryngeal pathologies. However, the epidemiology and clinical behavior of these tumors is not well studied. STUDY DESIGN Retrospective cohort study. METHODS Patients diagnosed with non-squamous cell larynx cancer from 2004 to 2017 in the National Cancer Database were selected. Demographic, clinicopathologic factors, treatments, and survival were analyzed. Univariable and multivariable cox regression were performed. Survival was compared with a propensity score-matched (PSM) population of laryngeal SCC patients. RESULTS A total of 136,235 cases of larynx cancer were identified. After excluding SCC variants, 2,172 (1.6%) patients met inclusion criteria. The most common histology was chondrosarcoma (374, 17.2%), followed by small cell (345, 15.9%), and spindle cell carcinoma (268, 12.3%). The most common treatment was surgery (683, 31.4%) followed by chemoradiation (409, 18.8%) and surgery and adjuvant radiation (288, 13.3%). Overall, 3- and 5-year survival was 67.9% and 59.4%, respectively. In multivariate analysis controlling for age, stage, comorbidity, histology, and treatment modality; chondrosarcoma had the best survival (hazard ratio [HR] 0.11, confidence interval [CI] 0.07-0.19, P < .001). In a PSM population, matched for age, stage, comorbidity, and treatments; non-SCC patients had significantly lower survival (51.5% vs. 59.9%, P < .001). CONCLUSION A diverse range of non-squamous cell malignancies occur in the larynx. In general, these tumors have poor survival, with few exceptions such as chondrosarcoma. While the majority of these histologies undergo surgical-based treatments in other sites, only 53% of patients underwent surgical-based treatment in the larynx. These data could guide clinicians in determining the outcome of treatment in these patients. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
Collapse
Affiliation(s)
- Janine M Rotsides
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Evan Patel
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Jamie R Oliver
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Lindsey E Moses
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Adam S Jacobson
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Kenneth S Hu
- Department of Radiation Oncology, NYU Langone Health, New York, New York, U.S.A
| | - Alec Vaezi
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Moses Tam
- Department of Radiation Oncology, NYU Langone Health, New York, New York, U.S.A
| | - Babak Givi
- Department of Otolaryngology-Head and Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| |
Collapse
|
22
|
Primary Skull Base Chondrosarcomas: A Systematic Review. Cancers (Basel) 2021; 13:cancers13235960. [PMID: 34885071 PMCID: PMC8656924 DOI: 10.3390/cancers13235960] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Primary skull base chondrosarcomas (SBCs) may carry significant tumor-burden by causing severe cranial nerve neuropathies. Current treatment strategies mainly focus on surgical resection and radiotherapy protocols, with a wide range of findings in terms of efficacy and safety. The aim of our systematic review was to comprehensively analyze the current literature on primary SBCs, describing clinical and radiological characteristics, available management strategies, treatment outcomes, and prognoses. We found that most primary SBCs show benign slow-growing patterns but may cause neurological deficits by compressing critical neurovascular structures. Open surgical approaches favor maximal resection with acceptable complication rates, but only a few studies reported the use of newer endoscopic approaches. Proton-based, photon-based, and carbon-based radiotherapy protocols may also allow safe and effective local tumor control as adjuvant treatments or stand-alone strategies in patients not eligible to undergo surgery. Overall, primary SBCs’ prognoses proved to be favorable and comparable to benign skull base neoplasms. Abstract Background: Primary skull base chondrosarcomas (SBCs) can severely affect patients’ quality of life. Surgical-resection and radiotherapy are feasible but may cause debilitating complications. We systematically reviewed the literature on primary SBCs. Methods: PubMed, EMBASE, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA guidelines to include studies of patients with primary SBCs. Clinical characteristics, management strategies, and treatment outcomes were analyzed. Results: We included 33 studies comprising 1307 patients. Primary SBCs mostly involved the middle-fossa (72.7%), infiltrating the cavernous-sinus in 42.4% of patients. Cranial-neuropathies were reported in 810 patients (62%). Surgical-resection (93.3%) was preferred over biopsy (6.6%). The most frequent open surgical approaches were frontotemporal-orbitozygomatic (17.6%) and pterional (11.9%), and 111 patients (21.3%) underwent endoscopic-endonasal resection. Post-surgical cerebrospinal-fluid leaks occurred in 36 patients (6.5%). Radiotherapy was delivered in 1018 patients (77.9%): photon-based (41.4%), proton-based (64.2%), and carbon-based (13.1%). Severe post-radiotherapy complications, mostly hypopituitarism (15.4%) and hearing loss (7.1%) were experienced by 251 patients (30.7%). Post-treatment symptom-improvement (46.7%) and reduced/stable tumor volumes (85.4%) showed no differences based on radiotherapy-protocols (p = 0.165; p = 0.062). Median follow-up was 67-months (range, 0.1–376). SBCs recurrences were reported in 211 cases (16.1%). The 5-year and 10-year progression-free survival rates were 84.3% and 67.4%, and overall survival rates were 94% and 84%. Conclusion: Surgical-resection and radiotherapy are effective treatments in primary SBCs, with acceptable complication rates and favorable local tumor control.
Collapse
|
23
|
Iandelli A, Missale F, Laborai A, Filauro M, Marchi F, Del Bon F, Perotti P, Parrinello G, Piazza C, Peretti G. Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study. Eur Arch Otorhinolaryngol 2021; 279:299-310. [PMID: 34557960 PMCID: PMC8738708 DOI: 10.1007/s00405-021-07076-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
Purpose Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC. Methods We collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan–Meier method. Results We identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi’s sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI95 2.15–16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies. Conclusion Non-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07076-x.
Collapse
Affiliation(s)
- Andrea Iandelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Francesco Missale
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
| | - Andrea Laborai
- Unit of Otorhinolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marta Filauro
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Filippo Marchi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Francesca Del Bon
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Pietro Perotti
- Unit of Otorhinolaryngology-Head and Neck Surgery, "S. Chiara" Hospital, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | | | - Cesare Piazza
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| |
Collapse
|
24
|
Vučković L, Klisic A, Filipović A, Popović M, Ćulafić T. Low-grade chondrosarcoma of the larynx: A case report. World J Clin Cases 2021; 9:7805-7810. [PMID: 34621830 PMCID: PMC8462258 DOI: 10.12998/wjcc.v9.i26.7805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/25/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chondrosarcomas of the larynx are malignant tumours that most commonly originate from the hyaline cartilage. Chondrosarcoma of the larynx, the most common type of low-grade tumour, accounts for 1% of all laryngeal neoplasms.
CASE SUMMARY We present the case of a 60-year-old female patient who developed progressive hoarseness and shortness of breath over a 2-mo period. The patient had undergone resection of a laryngeal tumour 14 years before the aforementioned symptoms occurred, and histopathological analysis indicated that it was a chondroma. During the assessment of the patient, a submucosal, oval-shaped tumour was detected that was predominantly located on the left side of the larynx and was approximately 6 cm in size. The decision to perform left partial vertical laryngectomy was made. A pathohistological diagnosis of low-grade chondrosarcoma was made. Considering the results of pathohistological analysis and the positive margins of the resection, a total laryngectomy was performed. During the 12-mo follow-up, no local relapse or regional or distant metastases was detected.
CONCLUSION Chondrosarcoma of the larynx must be considered in the differential diagnosis of laryngeal submucosal tumours. It is crucial to carefully sample of tumour tissue, differentiate chondroma and chondrosarcoma, and consider the possibility of malignant changes from chondroma to chondrosarcoma.
Collapse
Affiliation(s)
- Ljiljana Vučković
- Clinical Center of Montenegro, Department of Pathology, University of Montenegro-Faculty of Medicine, Podgorica 81000, Montenegro
| | - Aleksandra Klisic
- Primary Health Care Center, University of Montenegro-Faculty of Medicine, Podgorica 81000, Montenegro
| | - Aleksandar Filipović
- Clinical Center of Montenegro, Department of Endocrine Surgery, University of Montenegro-Faculty of Medicine, Podgorica 81000, Montenegro
| | - Mirko Popović
- Clinical Center of Montenegro, Clinic for Otorhinolaryngology and Maxillofacial Surgery, University of Montenegro-Faculty of Medicine, Podgorica 81000, Montenegro
| | - Tatjana Ćulafić
- Department of Pathology, Clinical Center of Montenegro, Podgorica 81000, Montenegro
| |
Collapse
|
25
|
Rüller K, Sittel C, Kölmel JC, Burghartz M, Steimer J, Fiz F, Piazza C, Peretti G, Fiz I. Organ Preservation Strategies in Laryngeal Chondrosarcoma. Laryngoscope 2021; 132:838-843. [PMID: 34418107 DOI: 10.1002/lary.29826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/27/2021] [Accepted: 08/07/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngeal chondrosarcoma (LC) is a rare, slowly growing malignancy. The preferred treatment is laryngeal preservation surgery (LPS). Some patients may require multiple interventions or total laryngectomy (TL). We investigated risk factors for retreatment and TL, and assessed the impact of LPS on oncological and functional outcomes. STUDY DESIGN Case series METHODS: We searched our institution database for LC. Tumor grading, localization, and margin status were tested as predictors of recurrence and organ preservation. RESULTS We included 21 patients (seven females, mean age 58 ± 12 years). LPS was applied in 20 (95.2%) of them as a primary procedure. Six patients were treated by transoral approach and 14 received "open-neck" LPS. Fifteen (71.4%) were operated only once, while six patients underwent a total of 15 adjunctive procedures. Additional operations were always performed for recurrence of tumors localized within the cricoid plate. The histological grading was G1 in 81% and G2 in 19%. However, two patients with a primary G1 LC showed a G2 recurrence. Reoperations for recurrence were more frequent among patients with G2 in respect to G1 histology (83% vs. 7%, P < .001). Fifty percent of G2 LC and 8% of G1 underwent TL (P < .05). Margin status had no influence on recurrence rate. CONCLUSIONS Patients with G2 LC have more recurrences requiring surgery and a higher incidence of TL. Cricoid plate localization is relevant for organ preservation. Margin status signals possible disease persistence, without influencing the need for future surgeries. Need for reoperation entails a risk of not being able to maintain organ functionality. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
Collapse
Affiliation(s)
- Karina Rüller
- Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Christian Sittel
- Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Jan-Constantin Kölmel
- Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Marc Burghartz
- Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Johannes Steimer
- Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Francesco Fiz
- Department of Radiology, Nuclear Medicine Unit, University of Tübingen, Tübingen, Germany
| | - Cesare Piazza
- Department of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Giorgio Peretti
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Ivana Fiz
- Department of Otorhinolaryngology, G. Gaslini Children's Hospital, Genoa, Italy
| |
Collapse
|
26
|
Zeitels SM, Baird BJ. Surgical Treatment Strategies for Laryngeal Chondrosarcomas: A Single Institution Investigation. Laryngoscope 2021; 132:169-176. [PMID: 34291467 DOI: 10.1002/lary.29762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/15/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngeal chondrosarcomas are rare malignancies with a spectrum of presentations due to varying size, local extension, and biological behavior. Moreover, these neoplasms have differing effects on respiration, phonation, and deglutition. Consequently, it is valuable to assess endoscopic and transcervical treatment strategies. STUDY DESIGN Retrospective case series. METHODS A retrospective review was done from 2001 to 2020; 25 patients were identified with laryngeal chondrosarcomas. Their tumor pathology and treatment were analyzed. RESULTS All 25 chondrosarcomas were in the posterior cricoid and arose in proximity to at least one cricoarytenoid joint: 23 of 25 grade I-II (low-mid), one of 25 grade II-III (mid-high), and one of 25 grade III (high). Some tumor was left in 23 of 25 to preserve cricoarytenoid-joint function. There were no known disease-specific deaths (~8-year median follow-up). Final surgical treatment in 24 of 25 was: 13 of 25 transcervical partial laryngectomy, 7 of 25 transoral-endoscopic removal, 4 of 25 total laryngectomy, and 1 of 25 observation. CONCLUSIONS In this series, unresected intercurrent disease with laryngeal chondrosarcomas was not life-threatening. Therefore, disease was typically left in the posterior cricoid region to preserve mobility of at least one cricoarytenoid joint. This philosophy employed an ultra-function-sparing conservation approach that preserved and/or restored optimal voice, airway patency and swallowing. LEVEL OF EVIDENCE 4, Case series Laryngoscope, 2021.
Collapse
Affiliation(s)
- Steven M Zeitels
- Department of Surgery-Harvard Medical School, Division of Laryngeal Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Brandon J Baird
- Department of Surgery, University of Chicago, Section of Otolaryngology-Head and Neck Surgery, Chicago, Illinois, U.S.A
| |
Collapse
|
27
|
Moen CM, Lim AE, Townsley RB. Low-Grade Chondrosarcoma of the Posterior Cricoid Plate. Cureus 2021; 13:e15400. [PMID: 34249549 PMCID: PMC8253495 DOI: 10.7759/cureus.15400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/05/2022] Open
Abstract
This case report presents an unusual case of chondrosarcoma arising from the cricoid cartilage of the larynx. Although these are commonly low-grade malignancies, this patient attended an outpatient respiratory clinic with acute airway obstruction, and went on to require a total laryngectomy due to the size of their tumour.
Collapse
Affiliation(s)
- Christy M Moen
- Ear, Nose and Throat, University Hospital Crosshouse, Kilmarnock, GBR
| | - Alison E Lim
- Otolaryngology, Queen Elizabeth University Hospital, Glasgow, GBR
| | - Richard B Townsley
- Otolaryngology - Head and Neck Surgery, University Hospital Crosshouse, Kilmarnock, GBR
| |
Collapse
|
28
|
Choi JS, Chopra S, O'Dell K. Lateral Vocal Fold Fullness in a Patient With Heavy Voice Use. JAMA Otolaryngol Head Neck Surg 2021; 146:760-761. [PMID: 32584371 DOI: 10.1001/jamaoto.2020.0941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Janet S Choi
- Keck School of Medicine, Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Shefali Chopra
- Keck School of Medicine, Department of Clinical Pathology, University of Southern California, Los Angeles
| | - Karla O'Dell
- Keck School of Medicine, Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| |
Collapse
|
29
|
Zając AE, Kopeć S, Szostakowski B, Spałek MJ, Fiedorowicz M, Bylina E, Filipowicz P, Szumera-Ciećkiewicz A, Tysarowski A, Czarnecka AM, Rutkowski P. Chondrosarcoma-from Molecular Pathology to Novel Therapies. Cancers (Basel) 2021; 13:2390. [PMID: 34069269 PMCID: PMC8155983 DOI: 10.3390/cancers13102390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Chondrosarcoma (CHS) is the second most common primary malignant bone sarcoma. Overall survival and prognosis of this tumor are various and often extreme, depending on histological grade and tumor subtype. CHS treatment is difficult, and surgery remains still the gold standard due to the resistance of this tumor to other therapeutic options. Considering the role of differentiation of CHS subtypes and the need to develop new treatment strategies, in this review, we introduced a multidisciplinary characterization of CHS from its pathology to therapies. We described the morphology of each subtype with the role of immunohistochemical markers in diagnostics of CHS. We also summarized the most frequently mutated genes and genome regions with altered pathways involved in the pathology of this tumor. Subsequently, we discussed imaging methods and the role of currently used therapies, including surgery and the limitations of chemo and radiotherapy. Finally, in this review, we presented novel targeted therapies, including those at ongoing clinical trials, which can be a potential future target in designing new therapeutics for patients with CHS.
Collapse
Affiliation(s)
- Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Sylwia Kopeć
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paulina Filipowicz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Andrzej Tysarowski
- Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| |
Collapse
|
30
|
Talati VM, Urban MJ, Patel TR, Wojcik C, Tajudeen BA, Stenson K, Bhayani MK, Al-Khudari S, Husain IA. Laryngeal Chondrosarcoma Characteristics and Survival Analysis in the National Cancer Database. Otolaryngol Head Neck Surg 2021; 166:101-108. [PMID: 33848444 DOI: 10.1177/01945998211004578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To highlight various patient, tumor, diagnostic, and treatment characteristics of laryngeal chondrosarcoma (LC) as well as elucidate factors that may independently affect overall survival (OS) for LCs. STUDY DESIGN Retrospective cohort study. SETTING National Cancer Database (NCDB). METHODS All LC cases from 2004 to 2016 were extracted from the NCDB. Several demographic, diagnostic, and treatment variables were compared between LC subgroups using χ2 and analysis of variance tests. Univariate and multivariate survival analyses were performed for LCs using univariate Kaplan-Meier analysis and Cox proportional hazards regression models. RESULTS There were 348 LCs included in the main cohort. LCs were predominantly non-Hispanic white males with similar rates of private and government insurance (49.4% vs 45.4%). Most LCs (81.6%) underwent primary surgery, particularly partial and total laryngectomy. The 1-, 5-, and 10-year survivals for LC were 95.7%, 88.2%, and 66.3%, respectively. On multivariate analysis, lack of insurance (P = .019; hazard ratio [HR], 8.21; 95% CI, 1.40-48.03), high grade (P = .001; HR, 13.51; 95% CI, 3.08-59.26), and myxoid/dedifferentiated histological subtypes (P = .0111; HR, 10.74; 95% CI, 1.71-67.33) correlated with worse OS. No difference in OS was found between partial and total laryngectomy. CONCLUSION This is the first multivariate survival analysis and largest single cohort study of LCs in the literature. Overall, LCs enjoy an excellent prognosis, with insurance status, grade, and histology as the main predictors of survival.
Collapse
Affiliation(s)
- Vidit M Talati
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Matthew J Urban
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Tirth R Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Kerstin Stenson
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Mihir K Bhayani
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Samer Al-Khudari
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Inna A Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
31
|
Clinicopathologic characteristics of laryngeal chondrosarcoma: An analysis of the National Cancer Database. Auris Nasus Larynx 2021; 48:956-962. [PMID: 33812757 DOI: 10.1016/j.anl.2021.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/05/2021] [Accepted: 02/16/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Laryngeal Chondrosarcoma (LC) is a rare malignancy with limited studies documenting its clinicopathologic characteristics and treatment options. This study reports demographic and clinical determinants of outcomes for this rare tumor. METHODS The National Cancer Database (NCDB) was queried for cases of LC reported from 2004-2016. 274 cases that met inclusion criteria were analyzed for demographic and clinicopathologic characteristics. Kaplan-Meier (KM) and Cox proportional hazard analyses were conducted to identify variables that impacted the overall survival of these patients. RESULTS LC was found to be more common in males (74.8%). The mean age of patients was 61.8 years and 92.3% of the patients were white. 91.3% of patients were treated with only surgical resection, most commonly: partial laryngectomy (31.6%), total laryngectomy (25.7%), and local resection (22.4%). 98.8% of patients had no evidence of nodal disease and 99.6% of patients did not have distant metastasis at presentation. KM analysis revealed a 5-year overall survival (5YOS) of 89.0%. Age, insurance status, facility type, and surgery type were significant predictors of 5YOS (p<0.05). On Cox Proportional Hazard analysis, private insurance significantly improved survival (HR 0.21; p = 0.048) while increasing age was a poor prognostic indicator (HR 1.10; p = 0.004). CONCLUSION The majority of LC patients present with no nodal involvement or distant metastasis at diagnosis, and overall this tumor has a favorable prognosis. Increasing age was found to be a poor prognostic factor while private insurance status was associated with improved survival.
Collapse
|
32
|
Kowa XY, Otero S, Jawad S. Head and neck sarcomas: imaging "pearls" and "mimics". Br J Radiol 2021; 94:20200922. [PMID: 33180558 DOI: 10.1259/bjr.20200922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Sarcomas are rare tumours, which can arise in any location in the head and neck. This review highlights the characteristic features of the commoner subtypes of bone and soft tissue sarcomas (including radiation-induced sarcomas), with emphasis on diagnostic "pearls" and imaging "mimics". This knowledge will help the radiologist formulate a differential diagnosis and expedite referral to a regional sarcoma unit for definitive management.
Collapse
Affiliation(s)
- Xin-Ying Kowa
- Department of Imaging, University College Hospitals London NHS Foundation Trust, London, UK
| | - Sofia Otero
- Department of Imaging, University College Hospitals London NHS Foundation Trust, London, UK
| | - Susan Jawad
- Department of Imaging, University College Hospitals London NHS Foundation Trust, London, UK
| |
Collapse
|
33
|
Astl J, Holy R, Tuckova I, Belsan T, Pala M, Rotnagl J. Sarcomas of the Larynx: One Institution's Experience and Treatment Protocol Analyses. ACTA ACUST UNITED AC 2021; 57:medicina57030192. [PMID: 33668739 PMCID: PMC7996352 DOI: 10.3390/medicina57030192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/15/2021] [Accepted: 02/19/2021] [Indexed: 12/04/2022]
Abstract
Soft tissue sarcomas in the head and neck are rare malignancies. They occur in this area in less than 1% of all malignant tumors. Some authors have described the development of sarcoma from the mesenchymal tissue in the larynx. The histological diagnosis of a sarcoma depends on the immunohistochemical investigation. In particularly difficult diagnoses, electron microscopy has to be used. The treatment recommendation depends on the histological type of sarcoma. We analysed and summarized data on the diagnostic criteria and therapy for sarcoma of the larynx presented in the literature. We present three new cases of laryngeal sarcoma and describe the analyses of the published diagnostic and treatment schedules of laryngeal sarcomas. We developed a treatment protocol recommendation for laryngeal sarcoma based on an analysis of literature data and case reports. This recommendation is based on histological type, staging, grading, size, and survival data.
Collapse
Affiliation(s)
- Jaromir Astl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic; (J.A.); (J.R.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
- Department of Otolaryngology, Institute of Postgradual Medical Education, 10005, Prague, Czech Republic
| | - Richard Holy
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic; (J.A.); (J.R.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
- Correspondence:
| | - Inna Tuckova
- Department of Pathology, Military University Hospital, 16902 Prague, Czech Republic;
| | - Tomas Belsan
- Department of Radiology, Military University Hospital, 16902 Prague, Czech Republic;
| | - Miloslav Pala
- Institute of Radiation Oncology, Bulovka University Hospital, 18081 Prague, Czech Republic;
- First Faculty of Medicine, Charles University, 12108 Prague, Czech Republic
| | - Jan Rotnagl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic; (J.A.); (J.R.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| |
Collapse
|
34
|
Daniels J, Durant S, Goswamy J. Functional optimisation in chondrosarcoma of the subglottis: a novel surgical approach. BMJ Case Rep 2021; 14:14/2/e236044. [PMID: 33563684 PMCID: PMC7875301 DOI: 10.1136/bcr-2020-236044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Chondrosarcoma of the larynx is rare accounting for approximately 1% of laryngeal cancers; clear cell subtype is a rare variant. Given the low risk of occult nodal disease, they present a unique opportunity to maximise tissue preservation in order to optimise both recovery and long-term functional outcomes. We present a case of laryngeal clear cell chondrosarcoma causing critical airway obstruction. An emergency tracheostomy was performed and mapping biopsies were taken. The tumour originated from the cricoid and extended into both arytenoid superstructures precluding cricotracheal resection. A modified narrow-field laryngectomy was performed, preserving all pharyngeal mucosa and neurovascularly intact infrahyoids. Organ preservation surgery is preferred in the management of laryngeal chondrosarcoma. If laryngectomy is required, the surgeon must ensure that all uninvolved, functional tissue is preserved carefully to improve swallow and voice outcomes postoperatively. We describe a novel technique used to achieve this outcome.
Collapse
Affiliation(s)
- Jessica Daniels
- ENT, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Susanna Durant
- ENT, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Jay Goswamy
- ENT, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| |
Collapse
|
35
|
Erdoğan Düzcü S, Coşgun Z, Astarcı HM. Laryngeal Chondrosarcoma of the Thyroid Cartilage. Turk Patoloji Derg 2021; 37:178-182. [PMID: 33021735 PMCID: PMC10512689 DOI: 10.5146/tjpath.2020.01509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022] Open
Abstract
Laryngeal chondrosarcoma is rare and accounts for 0.2% of all larynx malignancies. Although chondrosarcoma is the most common sarcoma seen in the larynx, laryngeal involvement by cartilage tumors is rare. In this article, we aimed to present the differential diagnosis of chondrosarcoma located in the thyroid cartilage, which is a rare site, in a 75-year-old male patient. The patient underwent total laryngectomy by the otolaryngology department. The macroscopy of the laryngectomy material sent to the pathology laboratory revealed a 3x2 cm tumor with a polypoid extension to the lumen from the bottom of the right vocal cord. Although clinical and radiological findings are important in the diagnosis, the definite diagnosis is based on the pathological examination. It is especially important to differentiate the lesion from chondromas.
Collapse
Affiliation(s)
- Selma Erdoğan Düzcü
- Department of Pathology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Zeliha Coşgun
- Department of Radiology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Hesna Müzeyyen Astarcı
- Department of Pathology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| |
Collapse
|
36
|
Ong AC, Huh EH, Moreland AJ, Rooper LM, Aygun N, Akst LM, Best SR, Khan MA. Nonepithelial Tumors of the Larynx: Single-Institution 13-Year Review with Radiologic-Pathologic Correlation. Radiographics 2020; 40:2011-2028. [PMID: 33035134 DOI: 10.1148/rg.2020190210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nonepithelial tumors of the larynx are rare and represent a minority of all laryngeal neoplasms. Imaging has an important role in the diagnosis, treatment planning, and surveillance of these entities. However, unfamiliarity with these neoplasms can cause diagnostic difficulties for radiologists, especially because many of the imaging findings are nonspecific. By using a systematic approach based on clinical history, patient age and gender, lesion location, endoscopic results, and specific imaging findings, the differential diagnosis can often be narrowed. These tumors typically affect the submucosal layer, so if a tumor has an intact mucosa at endoscopy, a nonepithelial neoplasm is the most likely diagnosis. Nonepithelial tumors of the larynx can arise from the laryngeal cartilage or muscle or from the surrounding lymphoid tissue or blood vessels. Consequently, imaging findings typically correspond to the specific cell type from which it originated. Recognizing specific features (eg, metaplastic bone formation, macroscopic fat, or enhancement pattern) can often help narrow the differential diagnosis. In addition, identification of noncircumscribed borders of the lesion and invasion of the adjacent structures is key to diagnosis of a malignant process rather than a benign neoplasm. Understanding the pathologic correlation is fundamental to understanding the radiologic manifestations and is ultimately crucial for differentiation of nonepithelial laryngeal neoplasms. Online supplemental material is available for this article. ©RSNA, 2020.
Collapse
Affiliation(s)
- Andrew C Ong
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Eric H Huh
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Anna J Moreland
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Lisa M Rooper
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Nafi Aygun
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Lee M Akst
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Simon R Best
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| | - Majid A Khan
- From the Russell H. Morgan Department of Radiology and Radiological Science (A.C.O., E.H.H., A.J.M., N.A., M.A.K.), Department of Pathology (L.M.R.), and Department of Otolaryngology-Head and Neck Surgery (L.M.A., S.R.B.), Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore. MD 21287
| |
Collapse
|
37
|
Ng C, Mentias Y, Abdelgalil A. Imaging features of non-epithelial tumours of the larynx. Clin Radiol 2020; 75:711.e5-711.e12. [DOI: 10.1016/j.crad.2020.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/23/2020] [Indexed: 12/27/2022]
|
38
|
Learned KO, Vu TH, Choi JM, Gule-Monroe MK, Pytynia KB, Ginsberg LE. Purulent chondritis of thyroid cartilage. BJR Case Rep 2020; 6:20200013. [PMID: 32922843 PMCID: PMC7465748 DOI: 10.1259/bjrcr.20200013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022] Open
Abstract
We report a case of a 77-year-old female with purulent chondritis of the thyroid cartilage who was initially referred for laryngeal neoplasm. Purulent chondritis of the laryngeal cartilage is a rare entity with three reports in the literature. The unique CT imaging features of expansile laryngeal cartilage with peripheral rim enhancement and central fluid-attenuation correlate to the abscess formation between the inner and outer perichondria. The correct imaging assessment prompts surgical management and avoid misdiagnosis.
Collapse
Affiliation(s)
- Kim O Learned
- Diagnostic Radiology, Neuroradiology (KOL, THV, MKG, LEG), and Head and Neck Surgery (KBP), University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Thinh H Vu
- Diagnostic Radiology, Neuroradiology (KOL, THV, MKG, LEG), and Head and Neck Surgery (KBP), University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeanie M Choi
- Diagnostic and Interventional Imaging, Neuroradiology, University of Texas Health Science Center, Houston, TX (JMC), USA
| | - Maria K Gule-Monroe
- Diagnostic Radiology, Neuroradiology (KOL, THV, MKG, LEG), and Head and Neck Surgery (KBP), University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kristen B Pytynia
- Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lawrence E Ginsberg
- Diagnostic Radiology, Neuroradiology (KOL, THV, MKG, LEG), and Head and Neck Surgery (KBP), University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
39
|
Gu J, Zuo Z, Sun L, Li L, Zhao N. Prognostic factors for laryngeal sarcoma and nomogram development for prediction: a retrospective study based on SEER database. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:545. [PMID: 32411768 PMCID: PMC7214913 DOI: 10.21037/atm-20-2970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Laryngeal sarcoma is an extremely rare malignant tumor of larynx and usually reported as case reports or small series. At present, there is no research based on big data about the prognostic factors affecting laryngeal sarcoma. Our study aimed to investigate the prognostic survival factors of laryngeal sarcoma and develop a comprehensive nomogram for predicting the survival of laryngeal sarcoma. Methods Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database to find patients diagnosed with laryngeal sarcoma from 1998 to 2016. The data were obtained using SEER Stat 8.3.5 software, collated, and analyzed by Excel 2016 software and SPSS (v25.0). Kaplan-Meier curves were used for survival analysis. The variables obtained by univariate analysis were introduced into the Cox proportional hazard model for multivariate analysis. The risk factors affecting the prognosis of laryngeal sarcoma were obtained (P<0.05 indicated statistical significance). The independent prognostic factors of laryngeal sarcoma were integrated and used to construct a nomogram. Results A total of 381 patients with laryngeal sarcoma were included. The median age of diagnosis was 67 years. The proportion of patients who had received surgical treatment was 62.73%, while 22.31% of patients had received no surgery. The 1-, 3-, 5-, and 10-year survival rates were 87%, 76%, 61%, and 45%, respectively. The median survival time was 102.35 months. Univariate analysis showed that increased age, primary site, pathology, pathological grade, and surgical treatment were significantly correlated with patient survival time and were risk factors for the patients' prognosis. Race, gender, and even lymph node metastasis were not significantly correlated with patient prognosis. The risk factors obtained from the univariate analysis were incorporated into the Cox risk model for multivariate analysis, the independent risk factors for prognosis of patients were: age (HR 1.569, 95% CI: 1.358–1.813, P<0.005), pathology (HR 0.834, 95% CI: 0.734–0.948, P<0.005), pathological grade (HR 1.433, 95% CI: 1.164–1.764, P<0.001), surgical treatment (HR 0.778, 95% CI: 0.696–0.870, P<0.000), primary site was excluded (P=0.092). We included all the risk factors from the multi-factor analysis to construct a nomogram, and the C-index value was 0.73, indicating that it was well-calibrated in the medium and long term. Conclusions Laryngeal sarcoma is a rare malignant tumor of the larynx, which most often affects people between the ages of 50 and 79 and males. Our study shows that age, pathology, pathological grade, surgical treatment may be the risk factors for patients’ prognosis. Based on this, we constructed a nomogram model with a prediction accuracy of 73% that could help clinicians make decisions on an individual basis.
Collapse
Affiliation(s)
- Jia Gu
- Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Zhifan Zuo
- China Medical University, The General Hospital of Northern Theater Command Training Base for Graduate, Shenyang 110016, China
| | - Lei Sun
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Li Li
- Department of Clinical Nutrition, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China
| | - Ning Zhao
- Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| |
Collapse
|
40
|
Chen L, Deng W, Li C, Lau H, Tao L, Wang S, Zhou L, Zhang M. Clinical outcome and comparison between squamous and non-squamous cell carcinoma of the larynx. Acta Otolaryngol 2020; 140:195-201. [PMID: 31852360 DOI: 10.1080/00016489.2019.1700305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The various pathological types of non-squamous cell carcinomas (nSCCs) of the larynx accounted for about 5% laryngeal malignancies, but the knowledge regarding these pathological behaviors, therapeutic models and prognostic factors was limited.Objectives: To investigate the clinical characteristics and the survival outcomes of nSCCs of the larynx.Material and methods: A total of 106 patients diagnosed with laryngeal nSCC between 2003 and 2014 were retrospectively investigated from a cohort of 4,796 patients with laryngeal malignancies.Results: Spindle cell carcinoma, malignant salivary gland carcinoma, neuroendocrine carcinoma, non-Hodgkin's lymphomas, and carcinosarcoma accounted for the majority of the nSCCs of the larynx. In laryngeal nSCCs (excluding non-Hodgkin lymphomas), there was no significant difference in overall survival (OS) by tumor subsite (p = .818), clinical-stage (p = .051) or T stage (p = .412), but the difference in OS by N stage was statistically significant (p = .001). Upon comparison of propensity score-matched groups, the OS was longer in SCCs of the larynx (p = .0004).Conclusions and significance: Primary nSCC of the larynx is rare, and its diagnosis depends on comprehensive immunohistochemical examination, as the clinical characteristics are non-specific compared with SCC. The overall prognosis of nSCC is relatively poor compared with that of SCC in the larynx.
Collapse
Affiliation(s)
- Le Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Weiye Deng
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cai Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Huiching Lau
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Lei Tao
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Shuyi Wang
- Department of Pathology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Liang Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Ming Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| |
Collapse
|
41
|
Escher P, Bu L, Cayci Z, Yueh B, Li F. Laryngeal Squamous Cell Carcinoma with Osteosarcomatous Differentiation and Involvement of Thyroid Cartilage Mimicking Sarcoma Arising from Thyroid Cartilage. Head Neck Pathol 2019; 14:771-777. [PMID: 31873935 PMCID: PMC7413955 DOI: 10.1007/s12105-019-01119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/18/2019] [Indexed: 11/29/2022]
Abstract
Basaloid squamous cell carcinoma (BSCC) with a spindle cell component of the head and neck is an uncommon entity. In this case, we present a radiology-pathology correlation of a rare laryngeal BSCC with sarcomatous transformation and osteosarcomatous differentiation involving the laryngeal cartilage, which thus mimicked clinically and radiographically osteosarcoma or chondrosarcoma with calcification. Microscopic examination revealed predominantly BSCC with extensive osseous metaplasia among sheets and nests of basaloid tumor cells. There were also small foci of osteosarcoma, undifferentiated pleomorphic sarcoma, and spindle cell carcinoma. The presence of squamous cell carcinoma (SCC) in-situ, small areas of conventional SCC and diffuse positivity of p40 in conventional and basaloid squamous components confirmed that this tumor was indeed derived from surface squamous epithelium. Awareness of the broad differentiation potentials of SCC can avoid misdiagnosis of SCCs as sarcoma. This case emphasizes the importance of radiologic-pathologic correlation in definitive diagnosis and clinical management of laryngeal malignancies.
Collapse
Affiliation(s)
- Paul Escher
- University of Minnesota Medical School, Minneapolis, MN USA
| | - Lihong Bu
- Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 76, C476 Mayo Building, 420 Delaware St. SE, Minneapolis, MN 55455 USA
| | - Zuzan Cayci
- Department of Radiology, University of Minnesota, Minneapolis, MN USA
| | - Bevan Yueh
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN USA
| | - Faqian Li
- Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 76, C476 Mayo Building, 420 Delaware St. SE, Minneapolis, MN 55455 USA
| |
Collapse
|
42
|
Galletti B, Costanzo D, Gazia F, Galletti F. High-grade chondrosarcoma of the larynx: treatment and management. BMJ Case Rep 2019; 12:12/9/e230918. [PMID: 31527210 DOI: 10.1136/bcr-2019-230918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We present a case of an 88-year-old man with high-grade chondrosarcoma of the larynx. The patient presents with a history worsening dysphonia and dyspnoea treated with antibiotic and corticosteroid therapy as it was a bronchopneumonia. Thanks to fibrolaryngoscopy, radiological imaging and final biopsy with immunohistochemistry, we have done differential diagnosis with the others sarcomas of the larynx. The histological diagnosis and the correct grading are essential for treatment and management of the pathology. The best treatment is primary surgical resection with negative margins. Chemoradiotherapy may provide some benefit if there are margin positive resections or with palliative intent. In our case, we performed only surgery treatment and a close follow-up at 1-3-6 months and after every 6 months. After 18 months from surgery, there are no signs of recurrence of disease.
Collapse
Affiliation(s)
- Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Daria Costanzo
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| |
Collapse
|
43
|
Ferlito A, Devaney KO, Mäkitie AA. Differing characteristics of cartilaginous lesions of the larynx. Eur Arch Otorhinolaryngol 2019; 276:2635-2647. [PMID: 31338576 PMCID: PMC6757023 DOI: 10.1007/s00405-019-05563-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/12/2019] [Indexed: 12/23/2022]
Abstract
Introduction The tissues of the laryngeal region only rarely harbor primary cartilaginous lesions, and squamous cell carcinoma remains the most frequently encountered malignant tumor in this area. Materials and Methods We reviewed the salient histological features of cartilaginous laryngeal lesions to provide differential diagnostics and guidelines for distinguishing the benign from the malignant ones. Results Cartilaginous neoplasms of the larynx include chondroma and chondrosarcoma. Among the overarching group of all forms of laryngeal sarcoma, chondrosarcoma forms the most common entity in the larynx, followed by rhabdomyosarcoma. Cartilaginous tumors comprise about 0.1%–1% of all laryngeal neoplasms with chondrosarcomas being more frequently encountered than chondromas. Several neoplasms earlier reported as giant-cell tumors of the larynx would most likely, using current terminology, be classified as cases of undifferentiated pleomorphic sarcoma (previously known as malignant fibrous histiocytoma, giant-cell variant) or aneurysmal bone cyst. Conclusion When true laryngeal sarcomas do exist, they may prove to be challenging lesions both for the pathologist and the treating clinician. The diagnostic problems are mainly a result of the infrequent exposure of clinicians and diagnosticians to these lesions.
Collapse
Affiliation(s)
- Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
| | | | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029 HUS,, Helsinki, Finland. .,Research Programme in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
| |
Collapse
|
44
|
Tallegas M, Miquelestorena-Standley É, Labit-Bouvier C, Badoual C, Francois A, Gomez-Brouchet A, Aubert S, Collin C, Tallet A, de Pinieux G. IDH mutation status in a series of 88 head and neck chondrosarcomas: different profile between tumors of the skull base and tumors involving the facial skeleton and the laryngotracheal tract. Hum Pathol 2019; 84:183-191. [DOI: 10.1016/j.humpath.2018.09.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/24/2018] [Accepted: 09/29/2018] [Indexed: 02/08/2023]
|
45
|
MLN4924, a Protein Neddylation Inhibitor, Suppresses the Growth of Human Chondrosarcoma through Inhibiting Cell Proliferation and Inducing Endoplasmic Reticulum Stress-Related Apoptosis. Int J Mol Sci 2018; 20:ijms20010072. [PMID: 30586948 PMCID: PMC6337205 DOI: 10.3390/ijms20010072] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022] Open
Abstract
Chondrosarcoma, a heterogeneous malignant bone tumor, commonly produces cartilage matrix, which generally has no response to conventional therapies. Studies have reported that MLN4924, a NEDD8-activating enzyme inhibitor, achieves antitumor effects against numerous malignancies. In this study, the suppressive effects of MLN4924 on human chondrosarcoma cell lines were investigated using in vitro and in vivo assays, which involved measuring cell viability, cytotoxicity, apoptosis, proliferation, cell cycles, molecule-associated cell cycles, apoptosis, endoplasmic reticulum (ER) stress, and tumor growth in a xenograft mouse model. Our results demonstrated that MLN4924 significantly suppressed cell viability, exhibited cytotoxicity, and stimulated apoptosis through the activation of caspase-3 and caspase-7 in chondrosarcoma cell lines. Furthermore, MLN4924 significantly inhibited cell proliferation by diminishing the phosphorylation of histone H3 to cause G2/M cell cycle arrest. In addition, MLN4924 activated ER stress–related apoptosis by upregulating the phosphorylation of c-Jun N-terminal kinase (JNK), enhancing the expression of GRP78 and CCAAT-enhancer-binding protein homologous protein (CHOP, an inducer of endoplasmic ER stress–related apoptosis) and activating the cleavage of caspase-4. Moreover, MLN4924 considerably inhibited the growth of chondrosarcoma tumors in a xenograft mouse model. Finally, MLN4924-mediated antichondrosarcoma properties can be accompanied by the stimulation of ER stress–related apoptosis, implying that targeting neddylation by MLN4924 is a novel therapeutic strategy for treating chondrosarcoma.
Collapse
|
46
|
Hernández-Brito C, Salazar-Álvarez MA, Álvarez-Bojórquez ME, Cisneros-Juvera FC, López-Gómez J, Elizalde-Méndez Á, Granados-García M. Laryngeal chondrosarcoma, case report and literature review. Int J Surg Case Rep 2018; 51:62-66. [PMID: 30144712 PMCID: PMC6108069 DOI: 10.1016/j.ijscr.2018.07.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 06/26/2018] [Accepted: 07/30/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Chondrosarcoma constitutes 0.2% of all malignant tumors of the larynx. Many surgeons treat it with total laryngectomy due to the limited experience with this neoplasm because its rarity, and although several conservative approaches have been proposed, the data of these techniques are limited and based on retrospective series. PRESENTATION OF CASE A 52-year-old male with a transglottic submucosal tumor and glottic stenosis in fiberoptic examination showed by tomography a laryngeal tumor that infiltrates vocal cords, glottis, cricoid and thyroid cartilage of 3 × 2.7 × 4 cm. Patient was submitted to total laryngectomy with selective bilateral neck dissection because obstructive tumor. Pathology reported a cricoid cartilage tumor consistent with grade 2 chondrosarcoma. DISCUSSION Biopsy by laryngoscopy is considered the standard procedure for the diagnosis of laryngeal tumors, however the need for general anesthesia and the difficulty in intubation in some patients with large tumors make difficult to obtain an adequate biopsy in some cases with submucosal tumor. Conservative surgeries should be individualized based on the size and location of the tumor as well as on the patient's general conditions. Radical treatment is recommended for high-grade and large tumors in which conservative surgery would destabilize the cricoid ring. CONCLUSION There is no diagnostic and treatment approach established for laryngeal chondrosarcoma, we believe that percutaneous biopsy would be the diagnostic test of choice because it is less invasive and has a high sensitivity and specificity; it could also identify patients who are candidates for conservative surgeries.
Collapse
Affiliation(s)
- Carlos Hernández-Brito
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico.
| | - María Alejandra Salazar-Álvarez
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| | - Mario Enrique Álvarez-Bojórquez
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| | - Francisco Carlos Cisneros-Juvera
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| | - Javier López-Gómez
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| | - Ángel Elizalde-Méndez
- Department of Oncologic Surgery, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| | - Martín Granados-García
- Department of Head and Neck, National Cancer Institute, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico City, Mexico
| |
Collapse
|
47
|
Abstract
IMPORTANCE Transoral robotic surgery has revolutionized the practice of head and neck surgery over the past decade, with indications now expanding to include laryngeal pathology. Although laryngeal chondrosarcoma is a rare entity, trends in otolaryngology literature suggest that it can frequently be managed with conservative approaches. We hope to inspire other head and neck surgeons to consider transoral robotic surgery for the treatment of such tumors so that outcomes data can be collected and studied. OBSERVATION An 87-year-old male presented with a left-sided supraglottic mass that was found incidentally on imaging performed for an unrelated reason. Flexible fiberoptic laryngoscopy revealed a cystic-appearing supraglottic mass with near complete obstruction of the glottis airway. Internal review of the imaging demonstrated a 3.5 by 2.3 by 2.8 cm centrally hypodense lesion with a rim of calcification in the left paraglottic space, with resultant narrowing of the laryngeal airway. INTERVENTION The patient underwent awake tracheostomy and transoral robotic subtotal resection of the mass using the Da Vinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA). The vocal folds, ventricular mucosa, and arytenoid cartilage were grossly preserved. Final pathology revealed a low-grade cartilaginous neoplasm consistent with low-grade chondrosarcoma. CONCLUSIONS AND RELEVANCE Chondrosarcoma of the larynx is a rare entity that accounts for roughly 1% of laryngeal neoplasms. Recent trends in otolaryngology literature and practice suggest that low-grade chondrosarcomas can be effectively treated with organ-preserving, conservative surgery. Transoral robotic surgery offers numerous advantages over both open and endoscopic approaches. To our knowledge, this is the first report in the literature describing the successful use of transoral robotic surgery for the resection of a laryngeal chondrosarcoma.
Collapse
|
48
|
Hellquist H, Hunt JL, Cardesa A, Skalova A, Slootweg PJ, Rinaldo A, Ferlito A. Role of ancillary techniques in profiling unclassified laryngeal malignancies. Virchows Arch 2018; 472:705-715. [PMID: 29623469 DOI: 10.1007/s00428-018-2348-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/09/2018] [Accepted: 03/26/2018] [Indexed: 12/31/2022]
Abstract
Laryngeal biopsies, contrary to biopsies from many other sites of the body, very often contain minute amounts of tumour tissue that may consist of morphologically undifferentiated tumour only. In haematoxylin- and eosin-stained sections, there may be no indicative features of what specific tumour entity that is present. In the larynx, particularly small round cell neoplasms, primary or metastatic, often cause a diagnostic dilemma and where an incorrect diagnosis can induce substantial clinical consequences for the patient (e.g., primary neuroendocrine carcinomas vs metastatic variants, certain sarcomas). If sufficient/representative material has been obtained, the application of immunohistochemistry and/or molecular techniques should in virtually every case reveal the true nature of the malignancy. In cases with sparse amount of material, and therefore a limited number of sections to be cut, a careful and thoughtful stepwise approach is necessary to ascertain a reliable diagnosis, or at least guide the clinician to the most likely diagnoses. With today's advanced and widely available technology with an abundance of markers to discriminate different tumours, the use of the term "undifferentiated" should be largely unnecessary. In the exceptional, and indeed exceedingly rare cases, when a classification is not possible, even after repeat biopsy, we suggest that the laryngeal neoplasm is better termed "unclassified malignant neoplasm" rather than "undifferentiated malignant neoplasm".
Collapse
Affiliation(s)
- H Hellquist
- CBMR, Centre for Biomedical Research, University of Algarve, Edificio 2, Ala Norte, University of Algarve, 8005-139, Faro, Portugal. .,Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. .,Algarve Biomedical Centre, Campus Gambelas, University of Algarve, Faro, Portugal.
| | - J L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - A Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
| | - P J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Rinaldo
- University of Udine School of Medicine, Udine, Italy
| | - A Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
| |
Collapse
|
49
|
Matrka L, Li M. Laryngeal Fracture following Violent Sneeze: Management and Biomechanical Analysis. OTO Open 2018; 2:2473974X18757741. [PMID: 30480206 PMCID: PMC6239027 DOI: 10.1177/2473974x18757741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/02/2017] [Accepted: 01/17/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Laura Matrka
- Department of Otolaryngology, The Ohio
State University, Columbus, Ohio, USA
| | - Michael Li
- College of Medicine, The Ohio State
University, Columbus, Ohio, USA
| |
Collapse
|
50
|
Navach V, Chu F, Cattaneo A, Zorzi S, Scelsi D, Ansarin M. Cartilage framework reconstruction after resection of thyroid cartilage chondrosarcoma: A case report. OTOLARYNGOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.xocr.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|