1
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Nguyen D, Htun NN, Johnson C. Gigantic laryngeal schwannoma: A case report with literature review. Rare Tumors 2024; 16:20363613241255669. [PMID: 38756435 PMCID: PMC11097735 DOI: 10.1177/20363613241255669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
Laryngeal schwannoma is a rare benign nerve sheath tumor that is slow growing. The diagnosis is made from a combination of clinical, radiological, and histopathological findings, and the main method of treatment is resection. We report a case of a 69-year-old presenting with a neck mass causing stridor, dysphagia, and orthopnea. CT of the neck showed an enhancing mass measuring 6.3 cm and extending superior to the larynx. Emergent tracheostomy and mass resection were performed, and histopathology and immunohistochemical findings were obtained from the specimen supporting schwannoma. In conclusion, while rare, schwannoma should always be considered as a differential diagnosis for a laryngeal mass. More studies are needed to assess the size and prognosis of the tumor.
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Affiliation(s)
- Daniel Nguyen
- Department of Pathology and Laboratory Medicine, University of California, Irvine Medical Center, Orange, CA, USA
| | - Nyein Nyein Htun
- Department of Pathology and Laboratory Medicine, University of California, Irvine Medical Center, Orange, CA, USA
| | - Cary Johnson
- Department of Pathology and Laboratory Medicine, University of California, Irvine Medical Center, Orange, CA, USA
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2
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Iliadou E, Fortune-Ely M, Melley LE, Garabet R, Sataloff RT, Rubin JS. Patients' Demographics and Risk Factors in Voice Disorders: An Umbrella Review of Systematic Reviews. J Voice 2024:S0892-1997(24)00080-8. [PMID: 38556378 DOI: 10.1016/j.jvoice.2024.03.006] [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: 02/20/2024] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES This study aimed to provide a comprehensive overview of the systematic reviews that focus on the prevalence of voice disorders (VDs), associated risk factors, and the demographic characteristics of patients with dysphonia. An umbrella review was conducted to identify general research themes in voice literature that might guide future research initiatives and contribute to the classification of VDs as a worldwide health concern. STUDY DESIGN Umbrella review of systematic reviews. METHODS Pubmed/Medline and Embase were searched for eligible systematic reviews by two authors independently. Extracted data items included the study publication details, study design, characteristics of the target population, sample size, region/country, and incidence and/or prevalence of the VD(s) of interest. RESULTS Forty systematic reviews were included. Sixteen reported a meta-analysis. Great heterogeneity in methods was found. A total of 277,035 patients across the included studies were included with a prevalence ranging from 0%-90%. The countries represented best were the United States and Brazil, with 13 studies each. Aging, occupational voice use, lifestyle choices, and specific comorbidities, such as obesity or hormonal disorders, seem to be associated with an increased prevalence of dysphonia. CONCLUSIONS This review underscores the influence of VDs on distinct patient groups and the general population. A variety of modifiable or non-modifiable risk factors, having varied degrees of impact on voice qualities, have been identified. The overall effect of VDs is probably underestimated due to factors, such as sample size, patient selection, underreporting of symptoms, and asymptomatic cases. Employing systematic reviews with consistent methodologies and criteria for diagnosing VDs would enhance the ability to determine the prevalence of VDs and their impact.
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Affiliation(s)
| | | | - Lauren E Melley
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia
| | - Razmig Garabet
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia
| | - Robert T Sataloff
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia
| | - John S Rubin
- University College London Hospital Trust, London, United Kingdom
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3
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Hamam YA, Alqeeq BF, Hamam M, Abuhelal AM, Saqer SA. Pediatric laryngeal schwannoma: a case report. J Surg Case Rep 2023; 2023:rjad587. [PMID: 37873048 PMCID: PMC10590634 DOI: 10.1093/jscr/rjad587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023] Open
Abstract
Schwannomas are benign tumors originating from Schwann cells in the peripheral nervous system. They mostly occur in the head and neck region but are rare in the larynx, and present with various symptoms. Surgical removal is the recommended treatment. This study presents a 12-year-old female with sudden onset hemoptysis, snoring, difficulty breathing, dysphagia, and voice changes. On examination, she was conscious and had muffled voice while speaking, without signs of respiratory distress. Endoscopic laryngoscopy revealed a large laryngeal mass obstructing the vocal cords. Endoscopic excision and biopsy confirmed the presence of the laryngeal schwannoma. Postoperative recovery was uneventful, with normal vocal cord function and no recurrence at follow-up.
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Affiliation(s)
- Yaser A Hamam
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Basel F Alqeeq
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Mohammed Hamam
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ahmed M Abuhelal
- Otolaryngology Department, Nasser Medical Complex, Gaza, Palestine
| | - Saleh A Saqer
- Otolaryngology Department, Nasser Medical Complex, Gaza, Palestine
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4
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Pasqualini MP, Bressan M, Lubianca JPN, Silva TL, Foinquinos GVG, Lubianca Neto JF. Unusual cause of progressing dysphonia and stridor in a child. Braz J Otorhinolaryngol 2023; 89:101308. [PMID: 37634405 PMCID: PMC10472233 DOI: 10.1016/j.bjorl.2023.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Marina Paese Pasqualini
- Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital da Criança Santo Antônio, Serviço de Otorrinolaringologia Pediátrica, Porto Alegre, RS, Brazil
| | - Mariele Bressan
- Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital da Criança Santo Antônio, Serviço de Otorrinolaringologia Pediátrica, Porto Alegre, RS, Brazil
| | | | | | | | - José Faibes Lubianca Neto
- Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital da Criança Santo Antônio, Serviço de Otorrinolaringologia Pediátrica, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Clínica Cirúrgica e Programa de Pós-Graduação em Pediatria, Porto Alegre, RS, Brazil.
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5
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Li H, Wang G, Zhang J. A Rare Laryngeal Schwannoma in an 11-Year-Old Boy. EAR, NOSE & THROAT JOURNAL 2023:1455613231162236. [PMID: 36866713 DOI: 10.1177/01455613231162236] [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: 03/04/2023] Open
Abstract
Schwannomas account for a large proportion of tumors in the head and neck regions; however, schwannomas of the larynx are rare. An 11-year-old boy had a sore throat for one month, and his symptoms gradually worsened such that he needed to visit our otolaryngology clinic. The preoperative investigation revealed a smooth mass in the left arytenoid cartilage. Endoscopy-assisted transoral resection of laryngeal masses was performed under general anesthesia, and the resected tissue was histopathologically diagnosed as a laryngeal schwannoma. The postoperative recovery was very good. During the 1-year follow-up, there was no recurrence of the schwannoma or related symptoms. Although laryngeal schwannomas are rare, they should be considered in the differential diagnosis of these tumors. Sufficient preoperative imaging should be performed before surgical resection, and surgery is the preferred treatment option.
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Affiliation(s)
- Hongbin Li
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Guixiang Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jie Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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6
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Singh I, Gopal A, Juneja R, Singh K, Kumar J, Batra R, Tomar R, Mandal S, Khurana N, Chaudhary D. Laryngeal schwannoma: A rare cause of hoarseness. OTOLARYNGOLOGY CASE REPORTS 2023. [DOI: 10.1016/j.xocr.2023.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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7
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Al-Yahya SN, Saifudin N, Rahim NA, Mansor M, Din S, Bakar NS. Supraglottic Schwannoma: Dilemma and Challenges in Management. Indian J Otolaryngol Head Neck Surg 2022; 74:5172-5176. [PMID: 36742766 PMCID: PMC9895650 DOI: 10.1007/s12070-021-03027-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023] Open
Abstract
Laryngeal schwannomas are rare lesions that represent less than 1.5% of all benign laryngeal tumors. Its slow and submucosal growth may cause a delay in consultation and management. Herein, a case of right supraglottic schwannoma is diagnosed in a 34-year-old lady who was unconcerned about hoarseness for 10 years. She was referred to otorhinolaryngology clinic for assessment when hoarseness was detected during consultation for a gynecology surgery. Apart from hoarseness, there were no noisy breathing, shortness of breath or aspiration symptoms. Flexible nasopharyngolaryngoscopy showed a submucosal bulge at the right vestibular fold obscuring the vocal fold causing an airway concern. Computer tomography scan of the neck revealed a heterogenous enhancing mass centered at the right supraglottis measuring 2.6 × 2.7 × 2.7 cm. There were no erosions of the adjacent thyroid and arytenoid cartilages. Subsequently, complete excision of the lesion was done endoscopically. Definitive diagnosis of schwannoma was obtained via histopathology examination. This paper presents our approach and operative steps in the excision of this lesion using microlaryngoscopy with cold instruments.
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Affiliation(s)
- Syarifah Nafisah Al-Yahya
- Department of Otorhinolaryngology Head and Neck Surgery, Sungai Buloh Hospital, Jalan Hospital, 47000 Sungai Buloh, Malaysia
| | - Norhafizah Saifudin
- Department of Otorhinolaryngology Head and Neck Surgery, Sungai Buloh Hospital, Jalan Hospital, 47000 Sungai Buloh, Malaysia
| | - Norazila Abdul Rahim
- Department of Otorhinolaryngology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Masaany Mansor
- Department of Otorhinolaryngology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Sobani Din
- Department of Otorhinolaryngology Head and Neck Surgery, Sungai Buloh Hospital, Jalan Hospital, 47000 Sungai Buloh, Malaysia
| | - Nor Salmah Bakar
- Department of Pathology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
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8
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Motter D, Wahba B. Laryngeal Schwannoma: A Rare Entity. Cureus 2022; 14:e31742. [DOI: 10.7759/cureus.31742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 11/22/2022] Open
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9
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Chen H, Guo Y, Li C, Zhou L. Paraglottic space schwannoma: a case report and literature review. J Int Med Res 2022; 50:3000605221122497. [PMID: 36113014 PMCID: PMC9478719 DOI: 10.1177/03000605221122497] [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] [Indexed: 11/17/2022] Open
Abstract
Neurogenic tumors located in the larynx are extremely rare. Among them, schwannoma is a
benign encapsulated tumor originating from Schwann cells, which form nerve fiber sheaths
in the peripheral nervous system. We herein report a case of a schwannoma arising from a
rare subsite of the larynx and review the literature on laryngeal schwannoma. The case
involved a woman with a 1-month history of globus pharyngeus and dysphagia without
dysphonia. Rigid laryngoscopy and magnetic resonance imaging showed a large submucosal
bulge toward the medial wall of the right pyriform fossa, pushing the right false and true
vocal cords and aryepiglottic fold inward. A transcervical approach was used to completely
excise the tumor without incisional biopsy or preliminary tracheotomy. Histology confirmed
a benign schwannoma originating from the right paraglottic space, which was extremely
rare. During follow-up, no evidence of recurrence or a residual mass was found. The
transcervical approach is a useful and less invasive treatment for laryngeal schwannoma
located in the paraglottic space.
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Affiliation(s)
- Hui Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otolaryngology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui District, Shanghai 200031, People's Republic of China
| | - Yang Guo
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otolaryngology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui District, Shanghai 200031, People's Republic of China
| | - Cai Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otolaryngology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui District, Shanghai 200031, People's Republic of China
| | - Liang Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otolaryngology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui District, Shanghai 200031, People's Republic of China
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10
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A Review of Microsurgical Resection of Recurrent Laryngeal Neurilemmoma Under Nerve Monitoring. J Craniofac Surg 2022; 33:e644-e647. [PMID: 35968945 DOI: 10.1097/scs.0000000000008722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Laryngeal neurilemmoma, especially recurrent laryngeal neurilemmoma, is a rare neural sheath tumor in head and neck. The most common symptom of laryngeal neurilemmoma is hoarseness or dysphonia, followed by dysphagia, dyspnea, and foreign body sensation. At present, surgical resection is the most effective treatment for this kind of tumor, thus making how to remove it become the most concerned problem of surgeons. CASE PRESENTATION On February 18, 2021, a 64-year-old male presented to our clinic with recurrent sore throat and intermittent hoarseness for 3 years. The results of electronic laryngoscope and magnetic resonance imaging showed a 25×10×21 mm well-defined tumor in the left pyriform sinus without laryngeal cartilage destruction and enlarged lymph nodes. After the initial diagnosis of recurrent laryngeal neurilemmoma, to preserve the continuity of recurrent laryngeal nerve as much as possible, the authors determine to perform anatomical resection of recurrent laryngeal neurilemmoma with operating microscope under the monitoring of recurrent laryngeal nerve function. Finally, the patient recovered completely from hoarseness during postoperative follow-up. CONCLUSION A complete diagnosis and treatment process of recurrent laryngeal neurilemmoma was presented by the case. Particularly, it shows the application of recurrent laryngeal nerve monitoring in the operation helps to protect the continuity of the recurrent laryngeal nerve, which lays a anatomical bases for the follow-up nerve repair.
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11
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Lopez J, Hamill EB, Burnstine M. Orbital schwannoma management: a case report, literature review, and potential paradigm shift. Orbit 2022; 41:15-27. [PMID: 33397169 DOI: 10.1080/01676830.2020.1858431] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE To present a case of orbital schwannoma and assess the literature on treatment modalities. METHODS A MEDLINE literature search for cases of orbital schwannomas was performed using the PubMed search tool using the search terms "orbital schwannoma" and "orbital neurilemmoma." Papers were included if they were peer-reviewed, published in English, discussed management, and included the search terms. Each article was rated using the scale developed by the British Centre for Evidence-Based Medicine. In addition, we present a case report of an orbital schwannoma. RESULTS A total of 428 articles were found. 102 met the criteria for inclusion. Only two articles met Level 1 evidence and 16 were important to the clinical care process. We report a case of a biopsy-proven orbital schwannoma managed conservatively with observation over a 4-year period due to risk of cosmetic disfigurement with tumor removal. There has been no change in tumor size and no associated complications during follow up. CONCLUSIONS There is a paucity of data on the natural history of orbital schwannomas. Based on our review of the literature, we recommend observation for asymptomatic or minimally symptomatic orbital schwannomas with minimal growth over an extended period of time. For rapidly growing tumors or large tumors affecting key structures causing visual loss, diplopia, aesthetic disfigurement, or patient discomfort, a more aggressive approach may be necessary.
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Affiliation(s)
- Jennifer Lopez
- Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Eric B Hamill
- Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern Califonrnia, Los Angeles, CA, USA
| | - Michael Burnstine
- Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern Califonrnia, Los Angeles, CA, USA
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12
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Kajiyama T, Komori M, Iguchi M, Nakashima J, Nagao A, Hyodo M. Laryngeal malignant peripheral nerve sheath tumor mixed with high- and low-grade malignancies. J Surg Case Rep 2021; 2021:rjab373. [PMID: 34476079 PMCID: PMC8407030 DOI: 10.1093/jscr/rjab373] [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: 07/17/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022] Open
Abstract
Malignant peripheral nerve sheath tumors (MPNSTs), as defined by immunohistochemical evaluation, are identified along a spectrum ranging from atypical neurofibroma to high-grade MPNST because these tumors are similar in terms of cell shape and tissue components on hematoxylin–eosin (HE) staining. The patient was a 57-year-old male referred to our hospital, with a recurrent red tumor at the anterior commissure of the larynx and submucosal swelling of the right vocal fold. A surgical specimen from a right horizontal partial laryngectomy was evaluated immunohistochemically. A high-grade MPNST lesion was included in the submucosal white tumor, whereas a low-grade MPNST lesion was encountered around the high-grade MPNST lesion. This tumor may involve different malignancies even when it is small. Although intra-tumor heterogeneity in cancers has been reported recently, careful immunohistochemical examination can be important and beneficial for eradicating the tumor while preserving vocal function.
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Affiliation(s)
- Taihei Kajiyama
- Department of Otolaryngology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Masahiro Komori
- Department of Otolaryngology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Mitsuko Iguchi
- Department of Pathology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Junko Nakashima
- Department of Pathology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Asuka Nagao
- Department of Otolaryngology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Masamitsu Hyodo
- Department of Otolaryngology, Kochi Medical School, Kochi University, Nankoku, Japan
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Tritter AG, Sadoughi B. Transoral Laser Microsurgical Excision of a Laryngeal Schwannoma Located in the Paraglottic Space. Laryngoscope 2021; 131:2729-2731. [PMID: 34014564 DOI: 10.1002/lary.29624] [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: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report the first case of transoral excision of a paraglottic laryngeal schwannoma. METHODS Case report. RESULTS Laryngeal schwannomas are rare tumors, with approximately 75 cases reported to date worldwide. Most cases involve superficial supraglottic tumors excised transorally, and some have been found in deeper compartments and treated using transcervical approaches. This report describes the first excision of a schwannoma of the paraglottic space via endoscopic laser laryngotomy. The procedure allowed return to normal function, without recurrence within 8 months, after which the patient was lost to follow-up. CONCLUSIONS Transoral excision of benign paraglottic tumors is safe and feasible. LEVEL OF EVIDENCE N/A. Laryngoscope, 2021.
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Affiliation(s)
- Andrew G Tritter
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, New York, U.S.A
| | - Babak Sadoughi
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, U.S.A
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14
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Hackenberg S, Kraus F, Scherzad A. Rare Diseases of Larynx, Trachea and Thyroid. Laryngorhinootologie 2021; 100:S1-S36. [PMID: 34352904 PMCID: PMC8363221 DOI: 10.1055/a-1337-5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review article covers data on rare diseases of the larynx, the trachea and the thyroid. In particular, congenital malformations, rare manifestations of inflammatory laryngeal disorders, benign and malignant epithelial as well as non-epithelial tumors, laryngeal and tracheal manifestations of general diseases and, finally, thyroid disorders are discussed. The individual chapters contain an overview of the data situation in the literature, the clinical appearance of each disorder, important key points for diagnosis and therapy and a statement on the prognosis of the disease. Finally, the authors indicate on study registers and self-help groups.
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Affiliation(s)
- Stephan Hackenberg
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Fabian Kraus
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Agmal Scherzad
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
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15
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Mariani C, Carta F, De Seta D, Nazhmudinov II, Guseinov IG, Magomedova KM, Chuchueva N, Marrosu V, Puxeddu R. Transoral-transpharyngeal CO 2 laser en bloc excision of voluminous left recurrent laryngeal nerve schwannoma: Case report and review of the literature. Clin Case Rep 2020; 8:3198-3203. [PMID: 33363906 PMCID: PMC7752612 DOI: 10.1002/ccr3.3372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/25/2020] [Accepted: 08/22/2020] [Indexed: 11/14/2022] Open
Abstract
Recurrent nerve laryngeal schwannoma is a rare benign tumor that, in expert hands, can be treated by transoral CO2 laser surgery.
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Affiliation(s)
- Cinzia Mariani
- Unit of OtorhinolaryngologyDepartment of SurgeryAzienda Ospedaliero‐Universitaria di CagliariUniversity of CagliariCagliariItaly
| | - Filippo Carta
- Unit of OtorhinolaryngologyDepartment of SurgeryAzienda Ospedaliero‐Universitaria di CagliariUniversity of CagliariCagliariItaly
| | - Daniele De Seta
- Unit of OtorhinolaryngologyDepartment of SurgeryAzienda Ospedaliero‐Universitaria di CagliariUniversity of CagliariCagliariItaly
| | - Ibragim I. Nazhmudinov
- The National Medical Research Center for OtorhinolaryngologyFederal Medico‐Biological Agency of RussiaMoscowRussia
| | - Ismail G. Guseinov
- The National Medical Research Center for OtorhinolaryngologyFederal Medico‐Biological Agency of RussiaMoscowRussia
| | - Kamilla M. Magomedova
- The National Medical Research Center for OtorhinolaryngologyFederal Medico‐Biological Agency of RussiaMoscowRussia
| | | | - Valeria Marrosu
- Unit of OtorhinolaryngologyDepartment of SurgeryAzienda Ospedaliero‐Universitaria di CagliariUniversity of CagliariCagliariItaly
| | - Roberto Puxeddu
- Unit of OtorhinolaryngologyDepartment of SurgeryAzienda Ospedaliero‐Universitaria di CagliariUniversity of CagliariCagliariItaly
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16
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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.
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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
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17
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Devries JK, Faraji F, Bracken D, Weissbrod PA. An Atypical Cause of Difficulty Swallowing. JAMA Otolaryngol Head Neck Surg 2020; 146:501-503. [PMID: 32191282 DOI: 10.1001/jamaoto.2020.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jacquelyn K Devries
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of California, San Diego
| | - Farhoud Faraji
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of California, San Diego
| | - David Bracken
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of California, San Diego
| | - Philip A Weissbrod
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of California, San Diego
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18
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Zhou J, Zhang D, Li W, Zhou L, Xu H, Zheng S, Wang C. Primary adrenal schwannoma: a series of 31 cases emphasizing their clinicopathologic features and favorable prognosis. Endocrine 2019; 65:662-674. [PMID: 31278687 DOI: 10.1007/s12020-019-01992-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/22/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE Primary adrenal schwannoma (PAS) is a very rare benign tumor, and most of them have been described in case reports. This study aimed to analyze their distinct clinicopathologic features and follow-up data through the largest series yet. METHODS Clinicopathologic features of 31 primary adrenal schwannomas were retrospectively studied. Imaging and histologic features were re-evaluated and summarized. Immunohistochemical markers were measured, including S100, SOX10, AE1/AE3, EMA, SMA, Desmin, HMB45, GLUT1, and Ki67. Follow-up of all cases was performed. RESULTS All the tumors were clinically misdiagnosed as nonfunctioning adrenal adenoma (NAA; 23/31), aldosterone-producing adenoma/aldosteronoma (APA; 3/31), cortisol-producing adenoma (CPA; 3/31), or pheochromocytoma (PCC; 2/31). Some 87% (27/31) presented with adrenal incidentaloma, and 13% (4/31) had a clinical symptom or unregulated hormone levels. They comprised conventional (19/31), cellular (7/31), plexiform (2/31), ancient (1/31), epithelioid (1/31) and microcystic/reticular variants (1/31) and had various histologic features. Immunohistochemically, all tumors (31/31) were positive for S100 and Sox10, with a low Ki-67 proliferative index. In the long-term follow-up (mean, 53 mo.; median, 56 mo.), none had evidence of recurrence and metastasis. Univariate analysis showed that OS and DFS were not associated with age; sex; tumor side, size, or number; adrenal-related symptoms; gross feature (solid vs. cystic); or any histologic feature (P > 0.9999). CONCLUSION PAS is an extremely rare tumor and mostly appears as an incidentaloma. Clinically, it tends to be misdiagnosed as other common adrenal tumors. This tumor has a benign biologic behavior and prognosis, without correlations with clinical or histologic parameters.
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Affiliation(s)
- Jun Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dandan Zhang
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wencai Li
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Luting Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haimin Xu
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Saifang Zheng
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chaofu Wang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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19
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Saraydaroglu O, Narter S, Ozsen M, Coskun H. Non-epithelial tumors of the larynx: case series of 12 years. Eur Arch Otorhinolaryngol 2019; 276:2843-2847. [PMID: 31256243 DOI: 10.1007/s00405-019-05527-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 06/18/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Laryngeal neoplasms are almost always epithelial in origin and squamous cell carcinoma is the most common tumor of the larynx. Non-epithelial tumors make a small subset of laryngeal neoplasms. We present the experience of a single institution to define clinical presentations and outcomes. MATERIALS AND METHODS The pathology archives and clinical records of our center with the diagnosis of laryngeal tumors between the 2005 and 2018 were reviewed. Age, gender, symptoms, location of the tumor, histopathological diagnosis, treatment modality and disease status were discussed. RESULTS 657 patients were diagnosed with laryngeal tumor between 2005 and 2018 and 13 patients with non-epithelial tumors were identified. The majority of the patients were male. The age ranged between 13 and 93 years. The most common tumor localizations were vocal cords and subglottis. Seven patients were diagnosed with malignant tumors and six patients had benign tumors. Chondrosarcoma was the most common malignant mesenchymal tumor. Others were leiomyosarcoma, fibrosarcoma and liposarcoma. The most common benign non-epithelial tumors were schwannoma and hemangioma. Plexiform neurofibroma and granular cell tumor were the other benign tumors. Eleven patients underwent excisional biopsy. One patient underwent partial laryngectomy and one had total laryngectomy. Three cases presented with recurrent tumor. Among the recurrent cases, two were malignant tumors. CONCLUSION Non-epithelial tumors of the larynx are rare and have a wide histological diversity. Immunohistochemical studies are of great importance in the diagnosis of these tumors. Primary mesenchymal tumors of the larynx should be kept in mind in differential diagnosis.
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Affiliation(s)
- Ozlem Saraydaroglu
- Department of Surgical Pathology, Faculty of Medicine, Uludag University, 16059, Gorukle, Bursa, Turkey.
| | - Selin Narter
- Department of Surgical Pathology, Faculty of Medicine, Uludag University, 16059, Gorukle, Bursa, Turkey
| | - Mine Ozsen
- Department of Surgical Pathology, Erzurum Regional Training and Research Hospital, 25240, Yakutiye, Erzurum, Turkey
| | - Hakan Coskun
- Department of Otorhinolaryngology, Faculty of Medicine, Uludag University, 16059, Gorukle, Bursa, Turkey
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20
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Costa ADS, Suzuki I, Palomino ALM, Gregorio MG, Scordamaglio PR, Jacomelli M. Multiple lar yngeal neuromas: rarebenign tumor. EINSTEIN-SAO PAULO 2019; 17:eAI4465. [PMID: 30892379 PMCID: PMC6422359 DOI: 10.31744/einstein_journal/2019ai4465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 09/05/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Iunis Suzuki
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | | | - Marcia Jacomelli
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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21
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Yang L, Hu L, Zhao W, Zhang H, Liu Q, Wang D. Endoscopic endonasal approach for trigeminal schwannomas: our experience of 39 patients in 10 years. Eur Arch Otorhinolaryngol 2018; 275:735-741. [PMID: 29350272 DOI: 10.1007/s00405-018-4871-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/08/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. METHODS A retrospective review of patients with TSs was undertaken to assess the outcome of endoscopic surgery from 2006 to 2016. Clinical features, imaging findings, preoperative/postoperative neurological deficits, surgical approaches and followed up data were collected. RESULTS Thirty-nine patients with TSs were included in this study. Surgical approaches include endoscopic medial maxillectomy approach (n = 8), endoscopic endonasal-assisted sublabial transmaxillary approach (n = 27) and endoscopic endonasal-assisted sublabial transmaxillary combined with septectomy (n = 4). Gross total resection and sub-total resection were achieved in 27 and 10 patients, respectively. The most common chief complaint was facial numbness, accounting for 41%, with a resolved rate of 62.5% after treatment. Fifteen patients developed new neurologic symptoms, including facial numbness/pain (n = 9 and 2, respectively), dry eye (n = 3) and mastication weakness (n = 1). Eight of these patients had partial improvement except for patients with dry eye. CONCLUSION Endoscopic endonasal approach represents a safe and effective surgical procedure for TSs in pterygopalatine fossa, infratemporal fossa and even Meckel cave. Tumor resection can be achieved by endoscope with few neurologic deficits and complications.
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Affiliation(s)
- Lu Yang
- Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Li Hu
- Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Weidong Zhao
- Department of Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Huankang Zhang
- Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Quan Liu
- Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Dehui Wang
- Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
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22
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Ayad JB, Nekro C, Rokhssi S, Lassikri O, Benbouzid MA, Essakalli L. [An unusual cause of high dysphagia: schwannoma of the preepiglottic space]. Pan Afr Med J 2017; 28:295. [PMID: 29675128 PMCID: PMC5903703 DOI: 10.11604/pamj.2017.28.295.14146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/19/2017] [Indexed: 11/11/2022] Open
Abstract
Les schwannomes sont des tumeurs mésenchymateuses, bien encapsulées des nerfs périphériques, de croissance lente. La localisation laryngée est exceptionnelle, nous présentons un cas non décrit dans la littérature de shwannome localisé au niveau de la loge hyothyroépiglottique. Une patiente de 50 ans, qui présentait une sensation de corps étranger depuis 4 ans, évoluant vers une dysphagie haute associée à une voix rauque. La laryngoscopie directe en suspension objectivait une masse supraglottique sous muqueuse régulière, réduisant la lumière pharyngo-laryngée. La TDM et l'IRM concluaient à une tumeur bénigne de la loge hyo-thyro-épiglottique. Une exérèse chirurgicale par voie externe a été réalisée et une trachéotomie première était nécessaire. L'examen histologique avec une étude immunohistochimique confirmait un schwannome bénin. Les suites post opératoires étaient simples. Aucune récidive n'était objectivée après 2 ans de recul.
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Affiliation(s)
- Jalila Ben Ayad
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Chaimae Nekro
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Safaa Rokhssi
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Omar Lassikri
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Mohamed Anass Benbouzid
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Leila Essakalli
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
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23
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du Plessis M, Hage R. Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010. Cancer Causes Control 2017; 28:1227-1239. [PMID: 28762075 DOI: 10.1007/s10552-017-0934-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 07/25/2017] [Indexed: 12/28/2022]
Abstract
Very little data exist on the incidence and burden of cancer in the individual Caribbean countries. Some data are available for larger areas, reported under a bigger geographical region; Latin America and the Caribbean, but many of the individual countries are not included. One of the main reasons is a lack of official cancer registries. Data are usually collected from hospital records or private physician records, and since it is not in an official registry, these data are not always accessible for inclusion in databases such as SEER and GLOBOCAN. Grenada is one of the countries that currently does not have a registry. Our aim is to report on the incidence for head and neck cancer with subcategories; hypopharynx, oropharynx, oral cavity, salivary glands, and larynx from data collected by the sole ear nose and throat specialist over a 20-year period. The age adjusted incidence per 100,000 for these cancers, whether combined or individually, is lower than that of similar populations. The incidence in males is only slightly higher than those reported in some parts of Africa. In females, only Eastern Africa is reported to have a lower incidence than that found in our study. While the incidence of oral cancers is lower than that of African Americans, the survival rate is comparable. Socioeconomic status, lack of infrastructure, and advanced stage at diagnosis appear to be closely related to the survival rate. Incidence reports suggest that incidence of head and neck cancers in individuals of African descent is lower than other populations. It is therefore not surprising that the incidence in Grenada is relatively low, although the incidence may be underestimated.
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Affiliation(s)
- Maira du Plessis
- Department of Anatomical Sciences, St Georges University, West Indies, Grenada.
| | - Robert Hage
- Department of Anatomical Sciences, St Georges University, West Indies, Grenada
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