Pediatric laryngeal cancer with 5-year follow up: case report

Advanced laryngeal squamous cell carcinoma in an adolescent: A case and treatment considerations

Pediatric laryngeal SCCa is a rare malignancy in childhood. High index of suspicion is critical to obtain timely tissue sample and diagnosis. Shared decision making is important when choosing treatment modalities for curative management, especially when working with adolescent patients.

Subglottotracheal Adenoid Cystic Carcinoma in a 16-Year-Old Female-A Case Report

Cystic adenoid carcinoma (ACC) is a rare malignant epithelial tumor arising from exocrine glands and accounts for only 1% of head and neck cancers. ACCs are common in the fifth and sixth decades of life, predominantly in women, and characterized by slow progression, local aggression, recurrence, and high metastasis. Subglottotracheal ACC is a rare tumor in the pediatric population, with only a few cases reported in the literature. We present a case of a 16-year-old female who was diagnosed with ACC in the subglottic and tracheal region. The patient presented with respiratory failure but without a history of dysphonia, dyspnea, stridor, or dysphagia. The diagnosis was confirmed by a biopsy, and subsequent imaging studies showed a large tumor involving the subglottic and tracheal region. The therapeutic management of this patient has been challenging due to the rarity of this tumor in the pediatric population and the potential long-term complications associated with tumor recurrence and psychological impact. This case highlights the diagnostic and therapeutic challenges in the management of subglottotracheal ACC in children and the importance of a multidisciplinary approach to optimize patient outcomes.

Paediatric laryngeal squamous cell carcinoma: Systematic review and pooled analysis

BACKGROUND

Paediatric squamous cell carcinoma (SCC) of the larynx is rare; however, recent data seem to support the notion that this pathology is increasing in incidence. Although this has been the case for several decades, treatment algorithms for this patient population remain identical to those of adults.

METHODS

The study consists of a systematic review and pooled analysis of oncologic outcomes in paediatric laryngeal SCC from a comprehensive literature search on OVID MEDLINE and EMBASE.

RESULTS

The average cohort age was 12.1 years. Nine (36%) had supraglottic primaries, and 16 (64%) had glottic primaries. Treatment included unimodal and combination therapy. No significant difference in survival was noted between surgically treated and non-surgically treated patients (5-year overall survival (OS): 68.2% vs 76.2%, P = .905), even when stratified for advanced-stage and supraglottic disease.

CONCLUSIONS

Paediatric patients with laryngeal HNSCC may have different presentations and responses to therapy than their adult counterparts.

Pediatric laryngeal tumors and demographics, management, and survival in laryngeal squamous cell carcinoma

OBJECTIVES

To evaluate the prevalence and features of pediatric laryngeal malignancies and to review the demographics, management, and survival of pediatric patients with laryngeal squamous cell carcinoma as compared to adult patients.

METHODS

Patients aged 0 (younger than 1) to 18 with laryngeal malignancy identified in the Surveillance, Epidemiology, and End Results (SEER) database were included from 1973 to 2016 published April 2019. Diagnosis of malignant laryngeal tumor was made using the 3rd edition of the International Classification of Diseases for Oncology (ICDO-3) code: C32.0 Glottis, C32.1 Supraglottis, C32.2Subglottis, andC32.9 Larynx primary site.

RESULTS

23 cases of pediatric laryngeal malignancies were identified. 16 cases were squamous cell carcinomas and 7 were other histologic types. Pediatric laryngeal SCC tended to be diagnosed in adolescence (mean age 14.8 years, range younger than 1 to 18, 82.6% of cases were age 12 and above). Management of laryngeal SCC included no recorded treatment (18.8%), primary radiation (18.8%), primary surgery (12.5%), radiation and surgery (25%), radiation and chemotherapy combined (18.8%), and surgery with radiation and chemotherapy (12.5%). Surgeries were local excision, excision and lymphnode dissection, as well as total laryngectomy, and not otherwise specified. The 2-year and 5-year overall and disease-specific survivals were 78.6%.

CONCLUSIONS

Pediatric laryngeal cancer is rare. Squamous cell carcinoma is the most commonly diagnosed malignant laryngeal histology affecting pediatric patients. Despite different risk factors, survival rates remain similar for pediatric patients with laryngeal squamous cell carcinoma as compared to adults. Physicians should include laryngeal cancer in the differential for pediatric patients with hoarseness, dysphagia, and progressive airway obstruction to avoid a late diagnosis.

Spontaneous regression of laryngeal carcinoma in 10 year old boy: A case report and review of literature

Laryngeal carcinoma is a rare pathology in children, with only 92 cases reported. Spontaneous regression of laryngeal carcinoma is even more unique clinical event, so far only observed in adults. In this report we present an extraordinary case of a 10 year old patient with laryngeal squamous cell carcinoma that underwent spontaneous regression.

Pediatrician approach to dysphonia

OBJECTIVE

The prevalence of voice disorders reaches up to 23.4% in the pediatric population and has a negative impact on quality of life. The objective of this study is to examine how pediatricians assess and manage patients with voice disorders and barriers they face when evaluating patients with dysphonia.

SUBJECTS AND METHODS

The study was designed as a cross-sectional survey. Pediatricians who are members of the North Carolina Pediatric Society or Duke University affiliated physicians were selected to participate in the study. They were emailed a description of the study with a link to a questionnaire regarding comfort level in recognizing an abnormal voice, how often they assess for dysphonia, barriers to evaluation of voice problems, reasons for referral, and common treatments employed.

RESULTS

A total of 1125 physicians were sent a questionnaire and 72 replied for a response rate of 6.4%. Of those who responded, only 16.7% routinely assess patients for voice problems. The most common reasons for not assessing patients for dysphonia include patients not complaining of voice problems or parents not concerned, and being unsure of the best method or available treatment options. Referrals were most commonly made when speech could not be understood or when the voice problem coincided with other neurological symptoms. Allergy and reflux medications were often trialed prior to referral. The majority of responders felt that voice problems impacted quality of life and 84.7% were interested in more information regarding pediatric voice problems.

CONCLUSION

Pediatricians encounter barriers in the assessment of voice problems in their patients. There is evidence from our study that they have interest in learning more about dysphonia. Otolaryngologists must continue to provide outreach to pediatricians to enhance the screening and management of patients with voice disorders.