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Sanchez Teran AI, Martínez Zamorano M, Trujillo Ortíz JA, Cerna Arriaga J. Renal cell carcinoma (RCC) spreading to the larynx: an unusual condition. BMJ Case Rep 2024; 17:e255459. [PMID: 38272511 PMCID: PMC10826486 DOI: 10.1136/bcr-2023-255459] [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: 01/27/2024] Open
Abstract
A man in his mid-70s, heavy smoker with chronic alcohol consumption and a chronic exposure to insecticides and burning of crop residues was referred to the surgical oncology department because of a 4-month onset of hoarseness, dyspnoea and laryngeal stridor. He had a history of left nephrectomy due to Fuhrman IV clear cell renal cancer 2 years ago. The patient underwent a bronchoscopy which identified a deforming tumour of the left vallecula, occlusion of 90% of the lumen and did not allow a safe biopsy. Following discussion between the oncological team, total laryngectomy and bilateral neck dissection of levels II, III, IV and V were performed, finding a transglottic tumour of approximately 4×3 cm with extension to the right anterolateral thyroid cartilage. The pathology report described metastatic RCC. The patient recovered well postoperatively and started systemic therapy with a vascular endothelial growth factor receptors inhibitor.
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Bandoh N, Kubota A, Takeda R, Sakaue S, Goto T, Baba S, Hashiba N, Kato Y, Nishihara H. Renal Cell Carcinoma Metastasizing to the Cricoid Cartilage Presenting With Subglottic Stenosis: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231177188. [PMID: 37231666 DOI: 10.1177/01455613231177188] [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: 05/27/2023] Open
Abstract
A 72-year-old Japanese man with a 4-month history of hoarseness and 1-week history of difficulty breathing was admitted to our department. He underwent right total nephrectomy for primary clear cell-type renal cell carcinoma (RCC) 6 years ago and left partial nephrectomy for the metastasis 4 years ago. Flexible laryngeal fiberscope examination revealed bilateral subglottic stenosis without obvious mucosal lesions. Enhanced computerized tomography (CT) scan of the neck revealed that the cricoid cartilage had become bilaterally expansive and tumorous lesion exhibiting enhancement. We performed tracheostomy on the appointed day and biopsied the tumor in the cricoid cartilage via the skin incision. Results of histologic and immunohistologic examinations for AE1/AE3, CD10, and vimentin positivity were consistent with clear cell-type RCC. Chest and abdomen CT scans revealed a few tiny metastases in the upper lobe of the left lung but no recurrence in the abdomen. At 2 weeks from the day of tracheostomy, total laryngectomy was performed. Postoperatively, the patient was treated transorally with axitinib (10 mg/day) and as of 12 months he remains alive with unchanging lung metastasis. Next-generation sequencing of targeted regions using a surgical specimen from the tumor revealed a frameshift mutation in the von Hippel-Lindau gene (p.T124Hfs*35) and a missense mutation in the TP53 gene (p.H193R).
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Affiliation(s)
- Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Akinobu Kubota
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Ryuhei Takeda
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Shota Sakaue
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Shogo Baba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Natsumi Hashiba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Yasutaka Kato
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Hiroshi Nishihara
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan
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Ahmed SS, Barik SK, Adhya AK, Das DK, Parida AV, Mukherjee P, Das Majumdar SK, Parida DK. Metastatic Renal Cell Carcinoma Masquerading as a Laryngeal Tumor: A Case Report. Cureus 2023; 15:e39229. [PMID: 37337489 PMCID: PMC10277151 DOI: 10.7759/cureus.39229] [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] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
Renal cell carcinoma (RCC) commonly metastasizes to various organs such as the lungs, liver, bones, and brain. However, isolated metastases to the head and neck region, especially the larynx, are very rare. This report presents a case of laryngeal growth that was eventually confirmed to be a metastatic deposit from an undiagnosed RCC. We report a case of a 66-year-old male who presented to the clinic with painless neck swelling and a change in voice. The scan showed a soft tissue mass in the thyroid cartilage. Histopathology of the resected laryngeal tumor confirmed metastatic clear cell carcinoma. A metastatic workup revealed a renal mass, and the patient underwent laparoscopic adrenal-sparing left cytoreductive nephrectomy. The histopathological examination established the diagnosis of clear cell RCC. Subsequently, the patient was treated with pembrolizumab and lenvatinib. Follow-up imaging showed no residual or recurrent lesions. This case highlights the rarity of laryngeal metastasis from RCC and the importance of an accurate diagnosis through advanced imaging and histopathological examination.
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Affiliation(s)
- Sk Soel Ahmed
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Sandip Kumar Barik
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Amit Kumar Adhya
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Deepak Kumar Das
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Archishnu Vedanta Parida
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Priyanka Mukherjee
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Saroj Kumar Das Majumdar
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Dillip Kumar Parida
- Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Haddad G, Sataloff RT, Hamdan AL. Laryngeal Metastatic Lesions: A Literature Review. J Voice 2022:S0892-1997(22)00170-9. [PMID: 35918235 DOI: 10.1016/j.jvoice.2022.06.016] [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: 05/06/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer ravages all aspects of a patient's life. In recent decades, there has been a substantial paradigm shift in the treatment of cancer with an emphasis on quality of life and patient comfort. Patients are treated holistically, a complex task given how multifaceted cancers are. Voice, a subtle indicator of patients' well-being is affected commonly by malignancies. One of the various ways by which voice is disturbed by non-laryngeal cancers is through metastasis to the larynx and adjacent areas. Metastasis to the larynx is rare but well-documented. If not diagnosed in a timely fashion, it can have devastating consequences on patients from life-threatening airway obstruction to progressive dysphonia that erodes their quality of life. Metastatic lesions of the larynx usually appear submucosal with intact overlying mucosa and are located most commonly in the supraglottis. Deep biopsies usually are needed for diagnosis, and management may entail endoscopic resection or other treatments. OBJECTIVES This paper reviews the literature to identify typical features of laryngeal metastatic lesions of the ten cancers that are among the most common worldwide, ie, skin, renal, breast, colorectal, lung, prostate, thyroid and liver. By summarizing their most prevalent locations in the larynx, type and appearance, the authors hope to aid physicians in their diagnostic process, particularly in cases in which laryngeal involvement is the first presenting sign of a malignancy.
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Affiliation(s)
- Ghassan Haddad
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Robert Thayer Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
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Eastwood MJ, Ahsan SF, Harris R. A rare case of isolated laryngeal metastasis 23 years after nephrectomy for clear cell renal carcinoma. Br J Hosp Med (Lond) 2021; 82:1-3. [PMID: 34431353 DOI: 10.12968/hmed.2021.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael J Eastwood
- Department of Ear Nose and Throat Surgery, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
| | - Syed F Ahsan
- Department of Ear Nose and Throat Surgery, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
| | - Richard Harris
- Department of Ear Nose and Throat Surgery, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
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Massaccesi M, Morganti AG, Serafini G, Di Lallo A, Deodato F, Picardi V, Scambia G. Late Tonsil Metastases from Renal Cell Cancer: A Case Report. TUMORI JOURNAL 2018; 95:521-4. [DOI: 10.1177/030089160909500420] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The occurrence of renal carcinoma metastasis to the head and neck region is extremely rare. Some authors have reported metastasis of renal cell carcinoma to the parotid glands, nose and paranasal sinus, tongue, larynx, thyroid and palatine tonsil. In this report we describe a rare case of renal cell cancer metastasized to the right tonsil in a 76-year-old man with previously diagnosed bone and lung metastases. To the best of our knowledge this is the first documented example of radiotherapy treatment in this type of presentation. Radiotherapy was effective in treating the lesion with satisfactory functional results.
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Affiliation(s)
- Mariangela Massaccesi
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Alessio G Morganti
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | | | | | - Francesco Deodato
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Vincenzo Picardi
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Giovanni Scambia
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
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Zenga J, Mehrad M, Bradley JP. Metastatic Cancer to the Larynx: A Case Report and Update. J Voice 2015; 30:774.e9-774.e12. [PMID: 26743607 DOI: 10.1016/j.jvoice.2015.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to describe a case of colorectal carcinoma metastatic to the larynx and provide a review of the current literature. METHODS A case report with chart review was performed. A review of the current literature was performed by systematically searching PubMed, OVID, CINAHL Plus, and EMBASE. RESULTS In 1988, a comprehensive literature review identified melanoma as the most common neoplasm to exhibit laryngeal involvement. Since that study, 41 subsequent cases have been reported, and among these, colorectal adenocarcinoma was the most frequent distant primary (24%). In 25 (58%) cases, curative surgery was attempted, but only 4 patients remained disease-free at last follow up. We report the history of a 52-year-old man who presented with rectal adenocarcinoma metastatic to his larynx 4 years after definitive treatment of the primary site. CONCLUSIONS In patients with a laryngeal mass and a history of colorectal cancer, or those at high risk of having an occult colorectal primary, metastatic spread to the larynx must always be considered. Although secondary laryngeal metastasis portends a poor prognosis, for the select patient, surgical intervention can provide long-term disease control.
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Affiliation(s)
- Joseph Zenga
- Department of Otolaryngology, Washington University, 660 S. Euclid Ave, Saint Louis, Missouri, 63110
| | - Mitra Mehrad
- Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213
| | - Joseph P Bradley
- Department of Otolaryngology, Washington University, 660 S. Euclid Ave, Saint Louis, Missouri, 63110.
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Sawicki P, Kaźmierczak W, Burduk P, Kaźmierczak H. Multiple metastases of renal clear cell carcinoma to the organs of the head. Contemp Oncol (Pozn) 2014; 18:448-51. [PMID: 25784846 PMCID: PMC4355657 DOI: 10.5114/wo.2014.47474] [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: 10/24/2013] [Revised: 12/05/2013] [Accepted: 12/27/2013] [Indexed: 11/17/2022] Open
Abstract
Metastases of renal clear cell carcinoma to the organs of the head are rare. Single cases show that they can appear either shortly after or many years after radical surgery. The diagnosis of this cancer is difficult because of its insidious course; therefore, it is often diagnosed too late. Late diagnosis is associated with a high risk of distant metastases and increased mortality. The paper presents a case of a patient whose kidney tumour was diagnosed during hospitalisation at the Department of Rheumatology. Further diagnosis and surgical treatment were performed in the Department of Urology, where a left-sided nephrectomy was carried out. After two years, the patient was hospitalised in the Department of Otolaryngology due to dysphagia. The patient was subjected to fine-needle biopsy, surgical biopsy, CT, and ultrasound. Metastases of renal clear cell carcinoma were diagnosed based on a histopathological examination and the results of imaging studies. Due to the extent of the tumour, diagnostics were extended to magnetic resonance imaging. The patient was qualified for tracheotomy, cytoreductive surgery, and chemoradiation. The patient was referred for further treatment at the Centre of Oncology in Bydgoszcz.
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Affiliation(s)
- Piotr Sawicki
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Wojciech Kaźmierczak
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Paweł Burduk
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Henryk Kaźmierczak
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
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Kusafuka K, Muramatsu K, Yabuzaki T, Ishiki H, Asano R, Kamijo T, Iida Y, Ebihara M, Onitsuka T, Kameya T. Alveolar soft part sarcoma of the larynx: a case report of an unusual location with immunohistochemical and ultrastructural analyses. Head Neck 2008; 30:1257-63. [PMID: 18286485 DOI: 10.1002/hed.20766] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alveolar soft part sarcoma (ASPS) is a rare mesenchymal neoplasm of uncertain origin. In this article, we report a case of ASPS occurring in the larynx, an extremely rare location for this rather unusual tumor. METHODS AND RESULTS The patient was a 34-year-old Japanese woman who requested an examination for hoarseness. The tumor showed a proliferation of large polygonal cells with periodic-acid-Schiff-positive diastase-resistant intracytoplasmic granules, arranged in an alveolar growth pattern. The cytoplasm of the tumor cells was eosinophilic. Tumor cells were positive for vimentin and titin. Nuclear immunoreactivity for TFE3 was observed, and the Ki-67 labeling index was 14.7%. Ultrastructurally, electron-dense rod-shaped crystals were infrequently observed in the cytoplasm. This case was finally diagnosed as ASPS of the larynx. CONCLUSION We discuss the histogenesis and differential diagnosis of ASPS with immunohistochemical and ultrastructural findings. TFE3 immunohistochemistry was found to be a very useful marker for the diagnosis of ASPS.
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Affiliation(s)
- Kimihide Kusafuka
- Pathology Division, Shizuoka Cancer Center Hospital and Research Institute, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
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Abstract
Renal carcinoma, the third most common urological cancer, induces presence of metastases in 75% of cases. The most affected sites for metastasis are the lungs, the lymphatic system, bones, the liver, adrenal glands and the brain with sometimes a cancer free period of several years prior to evolutionary recurrence of the disease. The aim of this literature review is to report on secondary uncommon renal localizations by underlining their clinical significance, as well as main characteristics, in order to provide guidelines for effective patient diagnosis and therapeutic management.
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Affiliation(s)
- A Vidart
- Service d'urologie, CHU Rouen, 1, rue de Germont, 76031 Rouen, France
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Daly SF, Sciubba J, Tufano RP. Lower-Extremity Liposarcoma Metastatic to the Larynx: Case Report. EAR, NOSE & THROAT JOURNAL 2006. [DOI: 10.1177/014556130608500316] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Distant metastases to the larynx are rare. We describe the case of a 46-year-old man who was referred to our head and neck surgery clinic with a 6-week history of sore throat and otalgia. He was found to have a laryngeal lesion that was consistent with a primary myxoid liposarcoma that had been extirpated from a lower extremity earlier. To the best of our knowledge, no case of myxoid liposarcoma metastatic to the larynx has been previously reported in the English-language literature.
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Affiliation(s)
- Scott F. Daly
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
| | - James Sciubba
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
| | - Ralph P. Tufano
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
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