Liposarcoma of the larynx

Liposarcoma of Larynx-A Case Report and Updated Review of Literature

Liposarcomas of the larynx is an extremely rare entity, and less than 50 cases have been published in English language literature. It is a malignant mesenchymal tumour arising from adipose tissue with a very high propensity for local recurrence. Well-differentiated liposarcomas are the most common variety but are challenging to diagnose because of their resemblance with benign tumors like lipoma and other malignant soft tissue sarcomas like myxoid chondrosarcoma. Therefore, immunohistochemistry (IHC) should be considered for confirmation. Wide local excision is the treatment of choice, and post-operative radiotherapy can be considered in cases of positive resection margins not amenable for revision surgery, high tumour grade, and myxoid variant. We are reporting a case of well-differentiated liposarcoma of the left aryepiglottic fold (AEF) in a 66-year-old man who was diagnosed to have a benign lipomatous lesion in the same location 3 years back. Based on the reports of the published cases, we are presenting a management algorithm for this entity.

Lipoma and liposarcoma of the larynx: case reports and literature review

OBJECTIVE

Two cases of laryngeal lipomatous tumors are presented. Their diagnoses and management are discussed and contrasted.

METHODS

Case report and literature review.

RESULTS

Patient 1 is a 58 year old male presenting with five years of progressive shortness of breath, dysphagia, and globus sensation. Clinical exam and imaging study showed a 3.5 cm hypodense laryngeal mass, and he underwent transoral robotic-assisted surgery for complete excision. Final pathology revealed a well-differentiated liposarcoma. Patient 2 is a 79 year old female presenting with one year of non-progressive hoarseness and globus sensation. Clinical examination and imaging study revealed a 1.8 cm hypodense laryngeal mass. Transoral endoscopic complete excision of the submucosal mass was performed. Final pathology revealed benign spindle-cell lipoma.

CONCLUSION

Liposarcoma and lipoma may present with similar symptomatology, clinical, and imaging findings. Pathology evaluation is of utmost importance for definitive diagnosis. Therefore, diagnosis and treatment of laryngeal lipomatous lesions are best accomplished with complete excision of the mass.

Laryngeal dedifferentiated liposarcoma

BACKGROUND

Soft tissue liposarcomas are quite common in the adult population, whereas liposarcoma of the larynx is exceedingly rare.

METHODS

We describe an exceptional case of liposarcoma of the posterior aspect of the left arytenoid in a 62-year-old woman who was treated with two endoscopic excisions and adjuvant radiotherapy (RT). This is the 32nd case of laryngeal liposarcoma reported in the English literature.

RESULTS

After a 20 months follow-up, no local, regional recurrences or distant metastases were detected, and no functional complications are described for the patient.

CONCLUSION

This case report highlights that endoscopic surgical treatment enables excellent organ and functional preservation. However, recurrence of laryngeal liposarcoma is the principal risk, so extended follow-up is essential. RT has no defined role in treatment but can be discussed, especially considering the surgical margins and recurrence status.

Liposarcoma of the larynx

OBJECTIVES

The objective was to review the presentation, diagnosis, treatment, and prognosis of patients with laryngeal liposarcoma (LLS). A case is reported, and a retrospective review of the English-language literature is presented.

METHODS

All published cases of LLS with adequate histopathologic documentation and clinical information were included for review.

RESULTS

Thirty cases of LLS have been reported. A majority of these patients are men between 40 and 70 years of age. The most common location of the tumor is the supraglottis, and the presenting complaints are similar to those of other laryngeal neoplasms. Although these neoplasms recur often and can cause significant morbidity, they are typically of low grade and rarely metastasize. The outcomes of this disease are generally good when it is treated with wide surgical excision.

CONCLUSIONS

Cases of LLS are extremely rare. Because the histologic changes are frequently subtle, LLS can be easily mistaken for a benign tumor. As a result, the diagnosis requires a high index of suspicion and diligence in examining biopsy specimens. Computed tomography and magnetic resonance imaging can assist in the diagnosis and surgical approach. Genetic and immunostaining analysis techniques may also prove to have valuable prognostic, diagnostic, and therapeutic implications for this disease. Wide surgical excision is the mainstay of treatment. The use of radiotherapy and chemotherapy in treating this cancer remains experimental, but might be considered on a case-to-case basis for palliation or to treat aggressive variants of the disease.

Dedifferentiated liposarcoma of the pyriform sinus: report of a case and review of the literature

Laryngeal and hypopharyngeal liposarcomas are extraordinarily infrequent tumors. To the best of our knowledge there are fewer than 40 well-documented cases reported to date. Almost all of them are well-differentiated liposarcomas, with only 2 laryngeal-hypopharyngeal dedifferentiated liposarcomas. Dedifferentiated liposarcoma is defined as a well-differentiated liposarcoma with areas of high-grade spindle cell nonlipogenic sarcoma. The well-differentiated areas may be of a lipoma-like, sclerosing, or mixed type, and the dedifferentiated areas most frequently are of malignant fibrous hystiocytoma-like type. Despite its commonly pleomorphic histology, dedifferentiated liposarcoma does not behave as aggressively as most pleomorphic sarcomas of adulthood; however, it has the capacity to metastasize, in contrast to its well-differentiated counterpart. We present a case of dedifferentiated liposarcoma arising in the pyriform sinus, an event only twice reported previously in the literature.

Upper aerodigestive tract liposarcoma: report on four cases and literature review

OBJECTIVE

To report on the clinical behavior, histopathology, treatment, and prognosis of laryngeal, hypopharyngeal, and cervical esophageal liposarcomas.

STUDY DESIGN

Retrospective reviews of pathology files and hospital records at a tertiary care hospital and a retrospective search of the English-language literature.

METHODS

Cases of upper aerodigestive tract (UADT) liposarcoma with adequate histopathologic documentation and clinical information were included for review.

RESULTS

Four cases of UADT liposarcomas were identified. The literature review revealed 26 cases of laryngeal liposarcomas, 7 cases of hypopharyngeal liposarcomas, and 6 cases of esophageal liposarcomas: the mean age at presentation was 55.8 years, the male:female ratio was 5:1, and 60% of the patients presented with dysphagia. Eighty-six percent of tumors had low-grade histologic findings. The recurrence rate after primary resection was 50%. Recurrence correlated with surgical procedure rather than with histologic subtype; 94.7% of recurrences happened after simple excision. Distant metastases occurred in three patients; two of them died of the disease.

CONCLUSIONS

The literature supports that UADT liposarcomas are rare and usually of low-grade histologic type. The rate of metastatic disease and tumor-related mortality is low. However, high recurrence rates have been noted, particularly when less radical surgery is employed.

[Liposarcoma of the larynx. Review of the literature apropos of a case]

Liposarcoma of the larynx is an uncommon tumor. Only 27 cases have been described in literature. We report a new case occurring in a 50-year-old patient. The treatment consisted of a total laryngectomy with lymph node dissection followed by adjuvant irradiation. Prognosis for laryngeal liposarcoma is better than that of non laryngeal liposarcoma. This tumor is at high risk of local recurrence and seldom has metastatic potential.

Liposarcoma of the larynx treated with radiotherapy

Liposarcoma of the larynx is an extremely rare malignancy. Only 18 cases have been reported in the literature. We herein report the first case of primary liposarcoma of supra-glottic larynx in a 53-years old male patient successfully treated with radiotherapy in August-September 1992. He currently remains free of the disease 4.5 years since the initial diagnosis.

Regional and distant metastases in laryngeal and hypopharyngeal sarcomas

Cervical node and distant metastases are the most important prognostic factors in malignant laryngeal neoplasms. Owing to the unusual occurrence of laryngeal sarcomas, the prevalence of their metastases has never been analyzed in detail. We reviewed the laryngeal sarcomas reported in the literature and noticed that both regional and distant metastases are rare events and variable for different histotypes. These observations have obvious therapeutic and prognostic implications.

Liposarcomas of the larynx and hypopharynx: a clinicopathologic study of eight new cases and a review of the literature

Laryngeal and hypopharyngeal liposarcomas were studied in seven men and one woman. Patient age ranged from 25 to 81 years, with a median of 64 years. Symptoms included dysphagia, airway obstruction, and the sensation of a foreign body in the back of the throat. Histologically, seven of the tumors were of the biologically favorable types, either representing well-differentiated (lipoma-like) liposarcomas or myxoid liposarcomas. One tumor was a pleomorphic liposarcoma. Six of the eight patients had one or more episodes of recurrent tumor. Surgery is the treatment of choice and can include conservative (organ-sparing) procedures. However, to eradicate the tumor completely and thereby prevent recurrent disease, open surgical approaches (i.e., lateral pharyngotomy), rather than endoscopic techniques should be employed. The morbidity rate for laryngeal and hypopharyngeal liposarcomas is high because these tumors tend to recur over extended periods of time. In this study, however, there were no instances of metastatic disease, and no deaths were attributed to liposarcoma. Prospectively, laryngeal and hypopharyngeal well-differentiated (lipoma-like) liposarcoma is a difficult clinical and histopathologic diagnosis to establish. Often, this diagnosis is made only after one or more episodes of recurrent disease.

Primary liposarcoma of the larynx. Case report and literature review

Laryngeal liposarcoma is an unusual tumor. Only 16 cases have been previously reported. We describe a new case of well-differentiated laryngeal liposarcoma and review the literature. The tumor was treated by surgical removal. Immunohistochemical study showed an immunophenotype consistent with liposarcoma. The case described is of the oldest patient (83 years old), the second to be found in a woman, and the second to be localized to one true vocal cord (according to the literature reviewed). The patient is still free of tumor 2 years later. The treatment and prognosis of liposarcoma of the larynx are discussed.

Liposarcoma arising in the cheek: report of a case and review of the literature

The following points can be made about liposarcoma of the oral cavity: 1) it is rare and slow growing; 2) it is often mistaken for a benign lesion; 3) there is a direct correlation of microscopic appearance with biological behavior and prognosis; 4) treatment is primarily surgical, with radiation used for selected cases; and 5) the better-differentiated tumors seem to respond more favorably to radiation.