Angiolipoma of the larynx

KTP-532 Laser Assisted Excision of a Rare Laryngeal Angiolipoma: A Case Report with Review of Literature

Angiolipoma is a benign mesenchymal tumor and its occurrence in head and neck region is very rare. Only 2 cases of Laryngeal angiolipomas have been reported in the medical literature. We present one such rare case in a 32-year-old male who presented with complaints of change in voice and foreign body sensation in the throat since past 9 months along with features suggestive of obstructive sleep apnoea and dysphagia. Contrast enhanced CT scan of the neck showed a cystic lesion arising from right ventricle extending superiorly till the vallecula, partially obstructing the airway. Suspecting a supraglottic cyst, trans-oral microlaryngoscopic KTP-532 laser assisted excision was planned, intraoperatively a solid tumor was encountered. We discuss herein the clinical presentation and management of this rare neoplasm with review of literature.

New Therapeutic Strategies in the Treatment of Stomal Recurrence After Total Laryngectomy: Role of Immunotherapy

OBJECTIVE

The aim of this study was to investigate the incidence of stoma recurrence and the therapeutic strategy outcomes in relation to survival that have been adopted over the past few decades using a monoclonal antibody, specifically nivolumab.

METHODS

This study included a total of 487 patients diagnosed with laryngeal carcinoma undergoing either a laryngectomy or salvage surgery after conservative interventions at the ENT Unit of Federico II University in Naples, Italy, between 2011 and 2021. Following a minimum 2.5-year follow-up and a maximum 21-year follow-up, the results revealed that only 38 patients suffered a stomal recurrence.

RESULTS

Despite various adopted treatment strategies, the literature reports lower patient survival rates. Following a total laryngectomy, stomal recurrence represents a therapeutic management challenge due to a poor prognosis for nearly every treated case. According to the literature, in fact, despite a low incidence (ie, 0.8-31.3%), the overall mortality rate increases from 77% to 100% after three years. Nevertheless, introducing immunotherapy into cancer treatment has resulted in an observable revolution in the treatment of different types of cancers over the years.

CONCLUSION

In light of recorded data on survival following the use of the nivolumab, the case presented in this study allows a new perspective of successfully treating recurrences of squamous carcinoma of the head and neck.

Strategies and Controversies in the Treatment With Carbon Dioxide Laser of Laryngeal Hemangioma: A Case Series and Review of the Literature

INTRODUCTION

The hemangioma is the most common vascular tumor, involving the head and neck in 60% of cases. It is rare in the larynx. In children, hemangiomas are more frequent on the subglottis, whereas in adults the most common site is the supraglottis. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present 2 cases of glottic hemangioma. Both patients reported severe hoarseness.

CASES

In the first patient, an extensive blue-purple mass was seen on the right vocal cord. The patient was posted for microlaryngeal surgery with carbon dioxide (CO₂) laser. Second patient had a large, smooth, flesh-colored polypoid mass emanating from the left vocal cord. The patient was posted for microlaryngeal surgery. After 2 months, both patients showed a considerable voice improvement.

DISCUSSION

Vocal cord hemangiomas are very rare, and they usually cause problem in the voice of the patient. A vascular lesion that may mimic a hemangioma may sometimes result from an organizing hematoma following a hemorrhage on the vocal cords due to voice abuse. Laryngeal hemangiomas also need to be distinguished pathologically from polypoidal vascular granulation tissue that may be produced by laryngeal biopsy, intubation, or trauma. Indirect endoscopy is enough to diagnosis. No active treatment is advised for adult laryngeal hemangiomas unless the lesions are symptomatic or show a tendency to involve other parts. There is no uniformly accepted treatment of head and neck hemangiomas. Surgical excision with laser CO₂ microlaryngoscopic techniques gives satisfactory results.

Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management

Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.

Focus on localized laryngeal amyloidosis: management of five cases

Amyloidosis is a group of idiopathic clinical syndromes caused by the deposition of insoluble fibrillar proteins (amyloid) in the extracellular matrix of organs and tissues. These deposits disrupt the function of the target organ. Amyloidosis can manifest as a systemic disease or a single-organ involvement (local form). Its etiology still remains unclear. Deposits of amyloid in the larynx are rare, accounting for between 0.2 and 1.2% of benign tumors of the larynx. In this retrospective study, we report the clinical aspects, diagnosis, treatment and follow-up of five female patients with localized laryngeal amyloidosis without systemic involvement. The patients were all treated successfully using microlaryngoscopy with CO₂ laser or cold instruments. Prognosis is excellent; however, appropriate follow-up is an important part of the long-term management of this disease in order to prevent and control the possibility of local recurrence.

Massive noninfiltrating angiolipoma of the buccal mucosa: Report of an extremely rare case

We present an extremely rare case of noninfiltrating angiolipoma (AL) of the buccal mucosa in a 90-year-old patient reaching a size of 14 cm × 10 cm. AL is rare in the soft tissues of oral cavity, and till date, only 22 cases have been reported, including our case. If size be taken into consideration, our case can be considered to be the first in literature to reach this massive size. Surgical excision of the tumor mass was performed. The histopathological findings confirmed the diagnosis of noninfiltrating AL. Follow-up for 1 year revealed no signs of recurrence.

Cellular infiltrative angiolipoma of cheek in an infant

Lipomas represent about 1 to 5% of all neoplasms of the oral cavity most commonly presenting as painless, mobile, soft, round mass. Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histological variants of lipoma arising from fat tissues. Although the angiolipoma is the most common tumour in the trunk and the extrimities of young people, it occurs infrequently in the head and neck region. In this article we present clinical, radiological and histological features of a cellular infiltrative angiolipoma exicised from the buccal mucosa of a 9 months old female child.

Angiolipoma in head and neck: report of two cases and review of the literature

Angiolipomas are either encapsulated or non-encapsulated fatty tumours. They are distinguished from other lipomas by the excessive degree of vascular proliferation and because they are mixed with mature adipocytes. They commonly occur in the trunk and extremities and are rare in the maxillofacial area. Only 36 cases in the head and neck have been reported in the literature. The authors report the first non-infiltrating intramasseterine angiolipoma, and a case of non-infiltrating angiolipoma of the cheek. These tumours appear as homogenous low-density areas on CT with no contrast enhancement. MRI gives better tumour delineation and clear definition of the location and longitudinal extent of the mass. Histopathology demonstrates mature adipose tissue and the proliferation of numerous small branching blood vessels. Management of angiolipomas requires complete surgical excision.

Non-infiltrating angiolipoma of the cheek: a case report and review of the literature

Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histologic variants of lipomas arising from fat tissue. Although angiolipoma is the most common tumor in the trunk and extremities of young people, it occurs infrequently in the head and neck region. The authors present the clinical and histological features of a non-infiltrating angiolipoma excised from the cheek of a 22-year old man. Clinical examination showed a soft, mobile, approximately 4 x 3 cm mass that could be palpated anterior to the masseter muscle. The mass was removed by an intraoral approach. Angiolipoma was confirmed on histopathologic evaluation. Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. They are usually painless, soft, round and mobile. The diagnosis is based on both clinical and histologic characteristics. The treatment is surgical excision.

Bronchial angiolipoma

Angiolipoma occurs preferentially in the extremities and trunk. We present a patient with involvement of the bronchus and describe successful localized resection of the lesion.

Angiolipoma of the Thyroid Gland

This is a report of an angiolipoma of the thyroid gland, an extremely rare entity. A thorough search of the literature revealed only one previously reported example. The patient was a 77-year-old woman with a history of a nodular lesion of the thyroid in the context of a multinodular goiter. A fine needle aspiration highlighted the presence of abundant adipocytes associated with numerous dilated vessels. Histopathologic examination of the lobectomy specimen documented the presence of a tumor composed of two main elements, namely, mature adipocytes and proliferating vessels, some of the latter containing fibrin thrombi.