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Laryngeal oncocytic cystadenoma and sudden death. Forensic Sci Med Pathol 2022; 18:554-556. [PMID: 36136290 PMCID: PMC9636096 DOI: 10.1007/s12024-022-00530-0] [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: 09/13/2022] [Indexed: 12/14/2022]
Abstract
An 86-year-old woman with Alzheimer disease collapsed in her nursing home and was not able to be resuscitated. At autopsy, the major findings were in the larynx where a pedunculated oncocytic cystadenoma had occluded the glottis. Oncocytic cysts or cystadenomas of the larynx are rare histologically benign lesions that account for only 0.1-1% of laryngeal lesions. While the usual presentation is of a sensation of a mass in the throat, hoarseness, or stridor, very occasionally, there may be acute airway compromise and sudden death. Oncocytic cystadenoma should, therefore, be included in the differential diagnosis of potentially lethal obstructive laryngeal lesions.
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Ongkasuwan J, Anzalone CL, Salazar E, Donovan DT. Presentation and Management of Giant Fibrovascular Polyps of the Hypopharynx and Esophagus. Ann Otol Rhinol Laryngol 2017; 126:29-35. [DOI: 10.1177/0003489416672872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Objective:Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management.Study Design:Case series.Setting:Tertiary academic institution.Methods:A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentation, diagnostic studies, and surgical approaches were reviewed. A review of the published literature was also performed.Results:The average age at presentation was 72 years (range, 59-85 years). Among the 4 patients, 2 presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; 2 underwent transcervical approaches with lateral pharyngotomy/esophagotomy, and the other 2 had endoscopic removal. The polyps arose from the hypopharynx in 3 patients and upper esophagus in 1. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp 2 years later and is currently being observed.Conclusion:Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that present in older adults. Although benign, they can cause life-threatening airway compromise that may necessitate tracheotomy. We present 4 cases of fibrovascular polyps and discuss our evolving surgical management, including endoscopic removal.
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Affiliation(s)
- Julina Ongkasuwan
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - C. Lane Anzalone
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Esperanza Salazar
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Donald T. Donovan
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
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Li P, Wang D, Li H, Chen X, Fang J. Hypopharynx giant fibrovascular polyps. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2017. [DOI: 10.1080/23772484.2017.1379355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Pingdong Li
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, People’s Republic of China
| | - Danni Wang
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, People’s Republic of China
| | - Haiyang Li
- Department of Otolaryngology, People’s Hospital of Beijing Daxing District, Beijing, People’s Republic of China
| | - Xiaohong Chen
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, People’s Republic of China
| | - Jugao Fang
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, People’s Republic of China
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Lee JW, Kim GH, Kim JK, Park CH, Song BG, Shin DH, Ha DW, Song GA. A Case of Giant Fibrovascular Polyp of the Esophagus, Treated Successfully by Endoscopic Resection. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2016; 67:253-256. [DOI: 10.4166/kjg.2016.67.5.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jong Wook Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Joong Keun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Chul Hong Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Byeong Gu Song
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Dong Hun Shin
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Dong Woo Ha
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Geun Am Song
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Maskovyak A, Felo J. Sudden Death Due to Asphyxia by Primary Tracheal Small Cell Carcinoma. Acad Forensic Pathol 2014. [DOI: 10.23907/2014.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Sudden natural asphyxial death in adults due to airway obstruction is an unusual cause of death. A variety of etiologies can cause airway obstruction, including benign or malignant tumors and soft tissue swelling from asthma, infections, or anaphylaxis. Malignant tracheal neoplasms are exceedingly rare with a reported incidence of approximately 2/1 000 000 and the small cell carcinoma subtype accounts for <10% of these tumors. We present a case of a 55-year-old female smoker who was found dead at home. At autopsy an obstructing lesion of the proximal trachea was identified that showed the characteristic cytomorphology of small cell carcinoma. No primary pulmonary lesions were identified. The cause of death was determined to be obstruction of the trachea by small cell carcinoma and the manner, natural.
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Affiliation(s)
- Amanda Maskovyak
- Pathology Resident at the Cleveland Clinic Foundation Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland, OH
| | - Joseph Felo
- Pathology Resident at the Cleveland Clinic Foundation Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland, OH
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Liu W, Yang X. A large, fleshy mass protruding outside the mouth. Gastroenterology 2014; 147:e1-2. [PMID: 25263299 DOI: 10.1053/j.gastro.2014.05.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 05/19/2014] [Accepted: 05/27/2014] [Indexed: 12/02/2022]
Affiliation(s)
- Wei Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinming Yang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Beylergil V, Simmons MZ, Ulaner G, Jurcic J, Hibshoosh H, Carrasquillo JA. FDG PET/CT findings in a rare case of giant fibrovascular polyp of the esophagus harboring atypical lipomatous tumor/well-differentiated liposarcoma. Clin Nucl Med 2014; 39:288-91. [PMID: 24458178 DOI: 10.1097/rlu.0000000000000358] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 70-year-old man with a history of chronic lymphocytic leukemia (CLL) underwent FDG PET/CT scan, which revealed a large polypoid soft tissue lesion in the esophagus with peripheral FDG avidity. An endoscopic biopsy revealed inflammatory changes with scattered CLL cells. The final histopathology demonstrated an 18-cm long and 4-cm wide giant fibrovascular polyp that was removed in 2 pieces. The polyp was composed of atypical adipose tissue with scattered giant cells and spindle-shaped cells as well as foci of CLL. Mouse double minute 2 homolog amplification was noted by fluorescence in situ hybridization diffusely in the giant polyp consistent with well-differentiated liposarcoma in a giant fibrovascular polyp.
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Affiliation(s)
- Volkan Beylergil
- From the *Molecular and Imaging Therapy Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York; †Department of Radiology, Weill Cornell Medical Center, New York, NY; ‡Department of Radiology, Memorial Sloan-Kettering Cancer Center, Basking Ridge, NJ; §Division of Hematology/Oncology, Department of Medicine, and ¶Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
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Kiho L, Byard RW. Acute fatal upper airway obstruction from an occult cavernous hemangioma of the larynx. J Forensic Sci 2014; 60 Suppl 1:S93-6. [PMID: 25131533 DOI: 10.1111/1556-4029.12587] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 11/17/2013] [Accepted: 12/21/2013] [Indexed: 11/27/2022]
Abstract
A 42-year-old previously well man collapsed while holding his throat. Resuscitation was unsuccessful, and at autopsy, the most significant findings were limited to the larynx, pharynx, and anterior mediastinum where there were multinodular dark blue tumors. Within the larynx, the lower border of the tumor was well demarcated, not extending beyond the vocal cords. A separate large polypoidal tumor mass was attached to the right aryepiglottic fold by a thin fibrous stalk. Histologic examination revealed numerous large, thin-walled cavernous-type vascular spaces typical of a multifocal cavernous hemangioma. Death was due to asphyxiation from obstruction of the upper airways by a cavernous hemangioma of the larynx. Adult laryngeal hemangiomas are rare and are usually supraglottic. This case demonstrates that pedunculated laryngeal cavernous hemangiomas may remain occult until the initiation of an obstructive episode with sudden collapse and death. In such instances, the diagnosis must rely upon an autopsy examination.
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Affiliation(s)
- Liina Kiho
- Department of Histopathology, Great Ormond Street Hospital for Children, London, UK
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Hinton-Bayre AD, Pham T. Dramatic presentation of a giant fibrovascular polyp of Laimer's triangle. ANZ J Surg 2014; 86:514-5. [PMID: 24889784 DOI: 10.1111/ans.12703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anton D Hinton-Bayre
- Department of Otolaryngology, Head and Neck Surgery, Royal Perth Hospital.,Ear Science Centre, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Tuan Pham
- Department of Otolaryngology, Head and Neck Surgery, Royal Perth Hospital
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