Laryngeal melanosis: a case report and review of the literature

Vocal Cord Melanosis: To Worry or Not to Worry?

Laryngeal Melanosis is a rare entity with unclear significance: whether it is a premalignant lesion for squamous cell carcinoma of the larynx or a sign of mucosal melanoma. In the few reported cases in the literature, it is descried as localised/diffused brownish discoloration of the mucosal surface of the involved subsite of the larynx. We hereby report a raised localised laryngeal melanosis of the vocal cord with an initial histopathology report of dysplasia.

Laryngeal melanosis

OBJECTIVE

Laryngeal melanosis (LM) is an unusual condition. Little is known about its clinical significance. To learn more about this unusual disorder, we prospectively gathered data on a series of patients with LM and compared the data with the summarized findings from the cases currently available in the literature.

STUDY DESIGN

Case series with planned data collection.

SETTING

Two hundred fifty-five-bed urban indigent care hospital located on a university medical center campus. Subjects and Methods Demographics, history, examination findings, and concurrent head and neck disorders were prospectively recorded for all patients with LM who presented to our institution between 2005 and 2012.

RESULTS

Eighteen patients with laryngeal melanosis were enrolled. All patients are African American, and all have a history of chronic tobacco use. The most common presenting symptom was dysphonia, and examination most often revealed flat, pigmented lesions of the larynx. Nine patients (50%) had concomitant squamous cell carcinoma of the upper aerodigestive tract. There are 19 previous cases of laryngeal melanosis reported by 12 different authors, with a concomitant carcinoma rate of 26%. Our patients are similar in age and are all African American, with a greater percentage of women and greater rate of concomitant carcinoma. Our study represents the single largest case series of laryngeal melanosis and is more complete given the prospective nature of the data collection.

CONCLUSION

Laryngeal melanosis is an unusual disorder that is associated with chronic tobacco use. Clinicians should be aware of the association between laryngeal melanosis and squamous cell carcinoma and perform a thorough evaluation for concomitant carcinoma.