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Pignataro L, Peri A, Pagani D, Iudica F, Scaramellini G. Cricoid Chondrosarcoma Coexisting with a Thyroid Mass: Case Report and Review of the Literature. TUMORI JOURNAL 2018; 92:257-9. [PMID: 16869248 DOI: 10.1177/030089160609200315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Laryngeal chondrosarcomas are rare cartilaginous tumors that usually present with hoarseness, dyspnea and, occasionally, dysphagia and dysphonia. We report the case of a low-grade chondrosarcoma of the cricoid cartilage coexisting with a right thyroid nodule, which presented with homolateral vocal fold paralysis. After a precautionary tracheotomy the patient underwent a laryngofissure in which the mass arising from the posterior plate of the cricoid cartilage was entirely enucleated. The histopathological analysis was compatible with a low-grade chondrosarcoma involving the posterior resection margin. For this reason, in agreement with the patient's wishes, a total laryngectomy and simultaneous right hemithyroidectomy were performed. We here discuss the peculiarity of the presentation and the therapeutic dilemma posed by this rare neoplasm.
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Affiliation(s)
- Lorenzo Pignataro
- Department of Otorhinolaryngology and Ophthalmological Sciences, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milan, Italy.
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Rizzo S, Strinati F, Longari F, Bizzotti C, Altissimi G, Frenguelli A. Chondrosarcoma of the Larynx: Presentation of a Case and Review of the Literature. TUMORI JOURNAL 2018; 94:864-8. [DOI: 10.1177/030089160809400617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chondrosarcoma of the larynx is a rare tumor of the upper respiratory tract that originates from cartilaginous tissue. The cricoid cartilage is the most frequent site of onset at the larynx. The diagnosis is not always easy, given the tumor's slow growth rate, the aspecificity of the symptoms, and the low degree of malignancy with which most cases present and which often causes it to be mistaken for a chondroma. A case is presented of a 61-year-old woman with a chondrosarcoma of the larynx, grade 2, originating from the cricoid cartilage and measuring about 3 cm in diameter. The patient underwent extirpation of the tumor together with the cricoid cartilage, with a successive thyrotracheal anastomosis because she refused a total laryngectomy, which would have been the indicated intervention on the basis of the extent and grade of the neoplasm. At 6 years from surgery, the patient is in a good state of health with good laryngeal function and without recurrence of the disease. This fact confirms that the surgical approach to chondrosarcoma of the larynx can in most cases be conservative, reserving demolitive surgery for the more aggressive forms, for tumors of greater extent, and for recurrences. In fact, good laryngeal function and therefore a good quality of life can be maintained even for long periods of time.
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Sun GH, Wang YJ, Gao LL, Qu N, Mu XM, Shi RL, Ji QH. Primary chondrosarcoma of the thyroid cartilage: Surgery-based management of a rare case. Oncol Lett 2017; 12:4435-4438. [PMID: 28101206 PMCID: PMC5228270 DOI: 10.3892/ol.2016.5257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/08/2016] [Indexed: 11/06/2022] Open
Abstract
In this study, we present a case of a 52-year-old male with a chondrosarcoma of the left lamina of the thyroid cartilage. Pre-operative evaluations detected typical calcifications and delineated the extent of the tumor. The patient underwent a total laryngectomy to ensure the complete resection of the tumor. The tumor was histopathologically found to consist of chondrocytes in a hyaline cartilage matrix. The patient's post-operative course has been successful apart from the permanent tracheostomy. Herien, we discuss the methods and rationales for the diagnosis and management of and recovery from this rare tumor, and also provide a review of the literature.
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Affiliation(s)
- Guo-Hua Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China; Department of Oncology, Shanghai Medical College, Fudan Universtiy, Shanghai 200032, P.R. China
| | - Yuan-Jin Wang
- Department of General Surgery, Yancheng First People's Hospital, The Fourth Affiliated Hospital of Nantong Medical College, Yancheng, Jiangsu 224000, P.R. China
| | - Li-Li Gao
- Department of Oncology, Shanghai Medical College, Fudan Universtiy, Shanghai 200032, P.R. China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Ning Qu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China; Department of Oncology, Shanghai Medical College, Fudan Universtiy, Shanghai 200032, P.R. China
| | - Xiang-Ming Mu
- Department of General Surgery, Yancheng First People's Hospital, The Fourth Affiliated Hospital of Nantong Medical College, Yancheng, Jiangsu 224000, P.R. China
| | - Rong-Liang Shi
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China; Department of Oncology, Shanghai Medical College, Fudan Universtiy, Shanghai 200032, P.R. China
| | - Qing-Hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China; Department of Oncology, Shanghai Medical College, Fudan Universtiy, Shanghai 200032, P.R. China
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Chin OY, Dubal PM, Sheikh AB, Unsal AA, Park RCW, Baredes S, Eloy JA. Laryngeal chondrosarcoma: A systematic review of 592 cases. Laryngoscope 2016; 127:430-439. [PMID: 27291822 DOI: 10.1002/lary.26068] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngeal chondrosarcomas are rare entities that arise from the cartilaginous structures of the larynx, including the cricoid, thyroid cartilage, epiglottis, and arytenoid cartilages. These tumors represent a minority of malignancies involving the larynx and can be mistaken for benign pathologies. The treatment has historically been surgical excision, often by total laryngectomy. This review investigates treatment modalities and patient outcomes. STUDY DESIGN Systematic review using PubMed/MEDLINE and EMBASE database. METHODS The databases were used to identify articles reporting cases of chondrosarcomas occurring exclusively in the larynx. Variables analyzed included patient demographics, presenting symptoms, grade, therapeutic approach, patient outcomes, and follow-up. RESULTS Five hundred and ninety-two cases were identified. The average age reported was 62.5 years. There was a 3:1 male to female ratio. The most common surgical approach was local excision in 178 cases, followed by total laryngectomy in 174 cases. Nonsurgical treatment such as radiotherapy and chemotherapy was only used in 0.8% and 0.2%, respectively. Disease-specific survival rates for 1, 5, 10, and 20 years were 97.7%, 91.4%, 81.8%, and 68.0%, respectively, with no differences when comparing 5-year survival rates for location, grade, and therapy. CONCLUSION Laryngeal chondrosarcomas are rare with a good prognosis. Various surgical approaches exist, with no difference noted in 5-year survival outcomes. Nonsurgical approaches were rarely used for these lesions. LEVEL OF EVIDENCE N/A. Laryngoscope, 2016 127:430-439, 2017.
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Affiliation(s)
- Oliver Y Chin
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A
| | - Pariket M Dubal
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A
| | - Ahmed B Sheikh
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A
| | - Aykut A Unsal
- Department of Otolaryngology and Facial Plastic Surgery, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, U.S.A
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A.,Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Newark, U.S.A
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, U.S.A.,Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Newark, U.S.A.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, U.S.A.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, U.S.A
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Pelliccia P, Pero MMD, Mercier G, Iannetti G, Makeieff M. Transoral Endoscopic Resection of Low-Grade, Cricoid Chondrosarcoma. Ann Surg Oncol 2014; 21:2767-72. [DOI: 10.1245/s10434-014-3668-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Indexed: 11/18/2022]
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Piazza C, Del Bon F, Grazioli P, Mangili S, Barbieri D, Nicolai P, Peretti G. Organ preservation surgery for low- and intermediate-grade laryngeal chondrosarcomas: Analysis of 16 cases. Laryngoscope 2013; 124:907-12. [DOI: 10.1002/lary.24416] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 08/21/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Cesare Piazza
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Francesca Del Bon
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Paola Grazioli
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Stefano Mangili
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Diego Barbieri
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Giorgio Peretti
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Genoa; Genoa Italy
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Cohen JT, Postma GN, Gupta S, Koufman JA. Hemicricoidectomy as the primary diagnosis and treatment for cricoid chondrosarcomas. Laryngoscope 2010; 113:1817-9. [PMID: 14520112 DOI: 10.1097/00005537-200310000-00029] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective was to present a new approach for the diagnosis and treatment of chondrosarcoma involving the cricoid cartilage. The technique involved an extramucosal resection of the ipsilateral half of the involved cricoid cartilage, providing enough tissue to be sent for pathological study, and resulted in good laryngeal function without jeopardizing patients' long-term survival. STUDY DESIGN Retrospective study. METHODS A retrospective study of eight patients who underwent hemicricoidectomy for cricoid chondrosarcoma was performed at the Center for Voice Disorders, Wake Forest University (Winston-Salem, NC). One patient was a woman and seven were men. The mean age at diagnosis was 64 years (age range, 53-72 y). RESULTS All patients had a low-grade tumor. Primary treatment included hemicricoidectomy in all cases. In six (75%) of the patients, tracheotomy was required at the initial surgery. The mean time for decannulation was 3.2 months (range, 5 d-1 y). In four cases a second procedure was required because of recurrence. The second procedure included two total laryngectomies and two endoscopic carbon dioxide laser excisions. The mean follow-up time was 3 years (range, 2 mo-10 y). At the time of writing, six patients were alive without recurrence, one patient was alive with disease; and one patient had died of unrelated causes. CONCLUSION The authors recommended unilateral hemicricoidectomy as the diagnosis and treatment of choice. This procedure allows sufficient tissue for histological study and provides good long-term breathing and phonatory function without compromising long-term survival. This procedure is appropriate for patients with 1) mobility of one vocal fold, 2) dysphonia or aphonia, and 3) an adequate subglottic airway.
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Affiliation(s)
- Jacob T Cohen
- Center for Voice Disorders, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157-1034, USA
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Merrot O, Gleizal A, Poupart M, Pignat JC. Cartilaginous tumors of the larynx: Endoscopic laser management using YAG/KTP. Head Neck 2009; 31:145-52. [PMID: 18972422 DOI: 10.1002/hed.20932] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Olivier Merrot
- Department of Otolaryngology-Head and Neck Surgery, Croix-Rousse Hospital, University Claude Bernard Lyon II, Lyon, France.
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9
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Lee S, Sparano A, Zhang P, Mirza N. Chondrosarcoma of the Arytenoid Cartilage: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708601216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the case of a 56-year-old black woman with a locally aggressive chondrosarcoma at an unusual tumor site: the right arytenoid cartilage. The tumor extended from the superior pole of the right arytenoid cartilage to the soft-tissue areas of the right aiyepiglottic fold, piriform sinus, and interarytenoid area. We undertook a conservative surgical approach by performing an endoscopic transoral CO2 laser resection, a right arytenoidectomy with wide soft-tissue margins, and a tracheotomy in anticipation of postoperative edema. Surgical exploration revealed that the tumor extended into the cricoid cartilage. Histopathology demonstrated a low-grade chondrosarcoma of the conventional variant. Clear margins were obtained by staged procedures. Chondrosarcomas of the larynx typically exhibit low-grade histopathology, and affected patients have a low incidence of metastasis and a good prognosis. Even so, these tumors can present diagnostic and therapeutic challenges. Surgical resection provides adequate airway protection and sound oncologic safety while preserving speech and swallowing, and these should be the surgeon's goals in this setting. Options include open laryngofissure, thyrotomy, organ preservation with partial laryngectomy, and endoscopic laser resection.
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Affiliation(s)
- Stella Lee
- Department of Otorhinolaryngology–Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - Anthony Sparano
- Department of Otorhinolaryngology–Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - Paul Zhang
- Department of Otorhinolaryngology–Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - Natasha Mirza
- Department of Otorhinolaryngology–Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia
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Guilemany JM, Ballesteros F, Blanch JL, Castro V. Hyoid and laryngeal chondrosarcomas have different clinicopathologic features. Acta Otolaryngol 2005; 125:683-6. [PMID: 16076723 DOI: 10.1080/00016480410024622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hyoid chondrosarcomas (CSs) are uncommon cervical tumours with different features compared to laryngeal CSs. Herein we report a hyoid CS in a 36-year-old male and review the literature. Only eight cases of hyoid CS have been reported to date. We have found important differences between hyoid and laryngeal CSs in terms of the age at presentation, gender, clinical symptoms, time before diagnosis, histologic findings and tumour size.
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Affiliation(s)
- J M Guilemany
- Department of Oto-Rhino-Laryngology, Hospital Clínic Barcelona, Barcelona, Spain.
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11
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Koufman JA, Cohen JT, Gupta S, Postma GN. Cricoid Chondrosarcoma Presenting as Arytenoid Hypertelorism. Laryngoscope 2004; 114:1529-32. [PMID: 15475775 DOI: 10.1097/00005537-200409000-00004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Arytenoid hypertelorism (arytenoid cartilages spaced too widely apart) appears to be the most common initial recognizable physical finding of cricoid chondrosarcoma. Nine cases from the Center for Voice Disorders are presented. With arytenoid hypertelorism caused by cricoid chondrosarcoma, usually the posterior larynx is open. In fact, patients with arytenoid hypertelorism caused by cricoid chondrosarcoma may be aphonic even though the anterior membranous vocal folds make contact during attempted phonation. METHODS Between 1991 and 2002, nine patients were diagnosed with cricoid chondrosarcoma. Patients' charts and video examinations were retrospectively evaluated for symptoms and the presence of arytenoid hypertelorism on endoscopic evaluation. Two were women, and seven were men, with a mean age of 70 (range 53-72) years at diagnosis. RESULTS Eight (88%) patients had aphonia or dysphonia caused by arytenoid hypertelorism as their presenting symptom. Six were diagnosed after failed medialization laryngoplasty or other laryngeal rehabilitation surgery. All nine patients had a low-grade tumor. The initial treatment in eight patients was hemicricoidectomy, and one patient had a total laryngectomy. In four cases, a second procedure was needed 1 to 6 years later because of recurrence. Seven patients are alive without clinically significant disease; one is alive with moderate disease, and one has died from an unrelated cause. CONCLUSIONS Severely dysphonic, elderly patients presenting with arytenoid hypertelorism of unknown cause should be evaluated by fiberoptic laryngoscopy and by computed tomography scan to rule out cricoid chondrosarcoma. Because these tumors behave so benignly, the authors recommend conservative surgery (unilateral hemicricoidectomy) as the diagnostic/treatment modality of choice.
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Affiliation(s)
- Jamie A Koufman
- Center for Voice Disorders of Wake Forest University, Winston-Salem, NC, USA.
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12
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Delaere PR, Vertriest R, Hermans R. Functional treatment of a large laryngeal chondrosarcoma by tracheal autotransplantation. Ann Otol Rhinol Laryngol 2003; 112:678-82. [PMID: 12940664 DOI: 10.1177/000348940311200805] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chondrosarcoma of the cricoid cartilage poses difficult therapeutic challenges. The tumor necessitates resection of parts of the cricoid cartilage with a resulting defect that is difficult to repair. We wanted to improve the functional outcome after resection of a lateralized chondrosarcoma by applying the technique of tracheal autotransplantation. The technique involves a 2-stage procedure, because the trachea needs at least 2 weeks for revascularization. Tracheal revascularization is the first stage, and is accomplished by wrapping the trachea in vascularized fascia (radial forearm). The second stage, performed after 14 days, consists of a hemilaryngectomy with tracheal autotransplantation. A case of a large unilateral chondrosarcoma of the cricoid cartilage with involvement of 1 cricoarytenoid joint is reported. The tumor was removed by hemicricohemilaryngectomy. After 2 weeks of tracheal revascularization, the cervical trachea was used to repair the laryngeal defect. The tumor was completely resected, and all laryngeal functions (swallowing, voice, respiration without tracheostomy) were restored. The patient remains tumor-free after a follow-up period of 3 years. Tracheal autotransplantation improves the functional treatment of lateralized chondrosarcomas of the cricoid cartilage.
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Affiliation(s)
- Pierre R Delaere
- Department of Otorhinolaryngology-Head and Neck Surgery, St Rafael University Hospital, Catholic University Leuven, Belgium
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Thompson LDR, Gannon FH. Chondrosarcoma of the larynx: a clinicopathologic study of 111 cases with a review of the literature. Am J Surg Pathol 2002; 26:836-51. [PMID: 12131151 DOI: 10.1097/00000478-200207000-00002] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chondrosarcomas of the larynx are rare tumors accounting for about 0.5% of all laryngeal primary tumors. A total of 111 laryngeal chondrosarcoma cases, diagnosed between 1970 and 1997, were retrieved from the Otorhinolaryngic-Head & Neck Tumor Registry of the Armed Forces Institute of Pathology. There was a 3.6:1 male/female ratio of patients 25-91 years of age (mean, 64.4 years). Patients presented most frequently with hoarseness (n = 72 patients) present for a mean of 28.2 months. The majority of tumors involved the cricoid cartilage (n = 77) with a mean size of 3.5 cm. All tumors were invasive and malignant by radiology and/or histology (into bone within the ossified laryngeal cartilages in 52 tumors). Most tumors were low-grade lesions: grade 1 (n = 51), grade 2 (n = 54); there were six grade 3 tumors. An associated benign chondroma with (n = 41 tumors) or without ischemia (n = 24 tumors) was noted. All patients had surgery and five had radiation therapy. Wide excision or voice-sparing surgery was used in 73 patients, whereas 37 patients had a laryngectomy. Recurrences occurred in 20 (18%) patients, 10 of whom underwent salvage laryngectomy. At the last follow-up, 102 patients had no evidence of disease (alive or dead, mean 11.2 years) and five patients had evidence of disease (alive, one patient, 6.5 years; dead, four patients, mean 6.4 years). The six patients with high-grade chondrosarcoma were all without disease at the last follow-up (mean, 15.1 years). There was no difference in clinical outcome based on grade (p = 0.210), location (p = 0.078), or treatment (p = 0.607) but was worse for patients with a myxoid-type chondrosarcoma (p = 0.044). Primary laryngeal chondrosarcomas are typically low- to moderate-grade lesions involving the cricoid cartilage, frequently associated with a chondroma. They usually portend an excellent overall long-term prognosis with initial conservative voice-sparing surgery.
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Affiliation(s)
- Lester D R Thompson
- Department of Endocrine and Otorhinolaryngic-Head & Neck Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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Aznar E, Nogués J, Moya J, Ramírez RD, García B, Maños M, Dicenta M. [Crico-tracheal chondrosarcoma]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2001; 52:603-6. [PMID: 11692951 DOI: 10.1016/s0001-6519(01)78254-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Chondrosarcoma is the most frequent mesenchymal tumor (nonepithelial) of the larynx. Radiographic studies and collaboration of pathologists have allowed that the number of cases diagnosed has increased considerably in the last few years. His privileged site is the subglotics. The late apparition of the symptoms delay the diagnosis, which is guided by CT scan and will be confirmed by histological examination of the surgical piece. The histological distinction between the different degrees of malignancy constitutes one challenge for the pathologist, so far, various criteria have been described for that aim. This biological behaviour is characterized by locoregional recurrence, in direct correlation with the grade of dedifferentiation. The treatment of choice is conservative surgical resection, and a regular follow up is obliged for early detection of recurrences and metastases. A case treated in our Center is presented, and the conclusions obtained after a literature review of the subject.
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Affiliation(s)
- E Aznar
- Ciudad Sanitariay Universitaria de Bellvitge, Barcelona
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15
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Shinhar S, Zik D, Issakov J, Rappaport Y. Chondrosarcoma of the Larynx: A Therapeutic Challenge. EAR, NOSE & THROAT JOURNAL 2001. [DOI: 10.1177/014556130108000820] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The diagnosis of laryngeal chondrosarcoma is likely to be missed because of its infrequent occurrence and its indolent pattern of growth. A 53-year-old woman came to our service with an 18-year history of hoarseness and increasing dyspnea. She had been previously documented as having left vocal fold paralysis and a bulging laryngeal mass. Computed tomography revealed the presence of a large calcified tumor that had caused a deformity of the larynx and an erosion of the arytenoid and cricoid cartilages. Direct laryngoscopy detected a large supraglottic mass with a normal-appearing mucosa. Total excision of the tumor was achieved through a lateral neck incision that spared the larynx. This case emphasizes the importance of a high index of suspicion for laryngeal chondrosarcoma in a patient who has unexplained vocal fold paralysis and a submucosal subglottic mass. Every effort should be made to take a conservative surgical approach that preserves laryngeal function when possible.
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Affiliation(s)
- Shai Shinhar
- Department of Otolaryngology, the Sourasky Medical Center, Tel Aviv, and the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Daniel Zik
- Department of Otolaryngology, the Sourasky Medical Center, Tel Aviv, and the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Jelena Issakov
- Department of Pathology, the Sourasky Medical Center, Tel Aviv, and the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yoram Rappaport
- Department of Otolaryngology, the Sourasky Medical Center, Tel Aviv, and the Sackler Faculty of Medicine, Tel Aviv University, Israel
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16
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Rinaldo A, Howard DJ, Ferlito A. Laryngeal chondrosarcoma: a 24-year experience at the Royal National Throat, Nose and Ear Hospital. Acta Otolaryngol 2000; 120:680-8. [PMID: 11099143 DOI: 10.1080/000164800750000199] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This paper presents a review of the experience of 12 patients with chondrosarcoma of the larynx treated at The Royal National Throat, Nose and Ear Hospital, London, over the last 24 years. This represents the largest European series and the third largest in the world. Chondrosarcoma is the most frequent non-epithelial malignant tumor of the larynx, with 83.3% of cases arising from the cricoid cartilage in our series. We have shown that deep wedge biopsy with a CO2 laser, aided by computerized tomography scanning, gives the most reliable diagnosis. Laryngeal chondrosarcoma is characterized by indolent growth, a potential for local recurrence and, infrequently, by metastases. The treatment details of our patients are discussed. Adequate partial resection is often successful and use of CO2 laser as the initial treatment in five of these cases is presented.
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Affiliation(s)
- A Rinaldo
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Italy
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17
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Ibarrola C, Vargas J, de Agustín P. Laryngeal chondrosarcoma: fine needle aspiration (FNA) of an unusual tumour. Cytopathology 1998; 9:130-4. [PMID: 9577740 DOI: 10.1046/j.1365-2303.1998.00070.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- C Ibarrola
- Department of Pathology, Hospital 12 de Octubre, Madrid, Spain
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Abstract
BACKGROUND Experience in the treatment of laryngeal chondrosarcoma is based on about 250 cases reported to date. The standard therapy is conservative surgery. Radiotherapy has universally been regarded as ineffective in the treatment of this disease. METHODS A patient with a laryngeal chondrosarcoma was observed for 11 years after radical radiotherapy. The literature on laryngeal chondrosarcoma was critically reviewed, with emphasis placed on radiotherapy. RESULTS The review of the literature revealed that experience with radiotherapy of laryngeal chondrosarcoma has been lacking, with fewer than 10 cases with short follow-up documented up to now. Meanwhile, increasing evidence of the efficacy of radiotherapy in the treatment of skeletal chondrosarcoma has emerged. The authors report the first case of chondrosarcoma of the larynx in which radical radiotherapy resulted in a long term remission of more than 10 years. CONCLUSIONS Radiotherapy should be considered when radical surgery is not feasible without severe mutilation. It should also be considered for the treatment of residual disease. Laryngectomy should be restricted to salvage treatment when radiotherapy fails. In this study, radiotherapy appeared to be an effective modality in the treatment of low grade laryngeal chondrosarcoma, and these results contrast with the current widespread disapproval of this treatment.
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Affiliation(s)
- S Gripp
- Department of Radiation Oncology, Heinrich-Heine-University Duesseldorf, Germany
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19
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Lewis JE, Olsen KD, Inwards CY. Cartilaginous tumors of the larynx: clinicopathologic review of 47 cases. Ann Otol Rhinol Laryngol 1997; 106:94-100. [PMID: 9041812 DOI: 10.1177/000348949710600202] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We reviewed the clinical and pathologic features of 47 laryngeal cartilaginous tumors treated at the Mayo Clinic. This represents the largest reported series of these tumors. The patient group consisted of 36 men (77%) and 11 women (mean age, 63 years; range, 44 to 91 years). The tumors included 44 chondrosarcomas, all low-grade, and 3 chondromas. The overall 5-year survival was 90.1%, which did not differ significantly from the expected survival. Laryngectomy was performed as primary treatment for chondrosarcoma in 6 patients. Of the patients with chondrosarcoma, 40% had tumor recurrence or symptomatic tumor progression at an average of 4.5 years after diagnosis. Only 15 of the patients with chondrosarcoma (34%) required total laryngectomy. There were no metastases, and 4 patients died of local disease (all received treatment before 1960). At latest follow-up, 34 patients with chondrosarcoma (77%) were alive without disease or had died of other causes. We conclude that laryngeal chondrosarcoma can be treated with conservative surgery in most cases, both initially and for recurrent disease.
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Affiliation(s)
- J E Lewis
- Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
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20
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Abstract
Although CS is the most common mesenchymal tumor of the larynx, there have only been approximately 200 cases reported to date. The nature, diagnosis, and management of these tumors are discussed. Although conservative therapy is acceptable in most instances, total laryngectomy may be opted for in cases of extensive tumor, high-grade lesions, and recurrences. CO2 laser excision for palliation has been shown to be a viable alternative in patients with high-operative risk. It is also shown that the behavior of these tumors is predictable, though not without some variation. Although these tumors are rare, CS must be considered when presented with a solid subglottic or neck mass.
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Affiliation(s)
- I D Bough
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
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