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Bandiera G, Covelli E, Elfarargy HH, Rogges E, Barbara M, Sabino L, Filippi C. Long-term follow-up after surgical management of laryngeal malignant pleomorphic sarcoma ‒ a case report. Braz J Otorhinolaryngol 2023; 89:101276. [PMID: 37315424 PMCID: PMC10391340 DOI: 10.1016/j.bjorl.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/20/2023] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Affiliation(s)
- Giorgio Bandiera
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy
| | - Edoardo Covelli
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy.
| | - Haitham H Elfarargy
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy; Kafrelsheikh University, Otorhinolaryngology Department, Kafrelsheikh, Egypt
| | - Evelina Rogges
- Sapienza University, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Rome, Italy
| | - Maurizio Barbara
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy
| | - Luigi Sabino
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy
| | - Chiara Filippi
- Sapienza University, Sant' Andrea University Hospital, Mental Health, and Sense Organs (NEMOS), Department of Neuroscience, Rome, Italy
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Velez Torres JM, Martinez Duarte E, Diaz-Perez JA, Leibowitz J, Weed DT, Thomas G, Civantos FJ, Arnold DJ, Gomez-Fernandez C, Rosenberg AE. Primary Sarcomas of the Larynx: A Clinicopathologic Study of 27 Cases. Head Neck Pathol 2021; 15:905-916. [PMID: 33686585 PMCID: PMC8384992 DOI: 10.1007/s12105-021-01314-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/19/2021] [Indexed: 01/21/2023]
Abstract
Primary sarcomas of the larynx are rare and are associated with diagnostic and treatment challenges. Studies of these tumors are limited, and most examples have been reported as small series. To further increase our understanding of laryngeal sarcomas, we reviewed our experience of an adult cohort. A retrospective search for laryngeal sarcomas from our pathology archives and consultation files of one of the authors was performed. We studied 27 primary laryngeal sarcomas that included 25 males, and 2 females, with a mean age of 60 years (range 33-85). The cases included conventional chondrosarcoma (16), well-differentiated liposarcoma (2), clear cell chondrosarcoma (1), leiomyosarcoma (2), high grade myxofibrosarcoma (2), high grade myofibroblastic sarcoma (1), low-grade myofibroblastic sarcoma (1), malignant granular cell tumor (1), and Kaposi sarcoma (1). Data on treatment and follow-up was available in 17 and 16 cases, respectively. 12 patients underwent partial laryngeal resection; five had total laryngectomy, and the patient with Kaposi sarcoma received combined highly active antiretroviral therapy and chemotherapy. Three patients developed local recurrence, and two patients developed metastases. The remaining patients with follow up had a favorable outcome and were disease-free after treatment. The important differential diagnosis of spindle cell sarcoma is sarcomatoid squamous cell carcinoma, and their distinction often requires extensive sampling of the mucosal surface and immunohistochemical analysis. The mainstay of treatment for laryngeal sarcomas is surgical removal, with the extent dictated by tumor type and grade. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.
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Affiliation(s)
- Jaylou M Velez Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4078, Miami, FL, 33136, USA.
| | - Ernesto Martinez Duarte
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julio A Diaz-Perez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4078, Miami, FL, 33136, USA
| | - Jason Leibowitz
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Donald T Weed
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Giovanna Thomas
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Francisco J Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - David J Arnold
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Carmen Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4078, Miami, FL, 33136, USA
| | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4078, Miami, FL, 33136, USA
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Cooper F, Moleron R, Chapman A, Shakeel M. Simultaneous double laryngeal tumours: a diagnostic and therapeutic challenge. BMJ Case Rep 2021; 14:14/2/e239797. [PMID: 33602770 PMCID: PMC7896599 DOI: 10.1136/bcr-2020-239797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Leiomyosarcomas are soft tissue tumours that rarely occur in the larynx. This case report describes the presentation and management of a 77-year-old man referred to the otolaryngology clinic with hoarseness who was found to have a large supraglottic leiomyosarcoma after panendoscopy and biopsies. He subsequently underwent laryngectomy for treatment of this tumour but, unexpectedly, the histological analysis of the laryngectomy specimen revealed a second primary tumour in the larynx-a squamous cell carcinoma (SCC). The patient had further treatment with neck radiotherapy. Three years after treatment, there are no signs of recurrence of either tumour. This case report discusses the very few similar cases of leiomyosarcoma coexisting with SCC in the larynx, collating the evidence surrounding the treatment of this rare presentation.
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Affiliation(s)
- Fergus Cooper
- Otolaryngology, Aberdeen Royal Infirmary, Aberdeen, UK
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Gu J, Zuo Z, Sun L, Li L, Zhao N. Prognostic factors for laryngeal sarcoma and nomogram development for prediction: a retrospective study based on SEER database. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:545. [PMID: 32411768 PMCID: PMC7214913 DOI: 10.21037/atm-20-2970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Laryngeal sarcoma is an extremely rare malignant tumor of larynx and usually reported as case reports or small series. At present, there is no research based on big data about the prognostic factors affecting laryngeal sarcoma. Our study aimed to investigate the prognostic survival factors of laryngeal sarcoma and develop a comprehensive nomogram for predicting the survival of laryngeal sarcoma. Methods Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database to find patients diagnosed with laryngeal sarcoma from 1998 to 2016. The data were obtained using SEER Stat 8.3.5 software, collated, and analyzed by Excel 2016 software and SPSS (v25.0). Kaplan-Meier curves were used for survival analysis. The variables obtained by univariate analysis were introduced into the Cox proportional hazard model for multivariate analysis. The risk factors affecting the prognosis of laryngeal sarcoma were obtained (P<0.05 indicated statistical significance). The independent prognostic factors of laryngeal sarcoma were integrated and used to construct a nomogram. Results A total of 381 patients with laryngeal sarcoma were included. The median age of diagnosis was 67 years. The proportion of patients who had received surgical treatment was 62.73%, while 22.31% of patients had received no surgery. The 1-, 3-, 5-, and 10-year survival rates were 87%, 76%, 61%, and 45%, respectively. The median survival time was 102.35 months. Univariate analysis showed that increased age, primary site, pathology, pathological grade, and surgical treatment were significantly correlated with patient survival time and were risk factors for the patients' prognosis. Race, gender, and even lymph node metastasis were not significantly correlated with patient prognosis. The risk factors obtained from the univariate analysis were incorporated into the Cox risk model for multivariate analysis, the independent risk factors for prognosis of patients were: age (HR 1.569, 95% CI: 1.358–1.813, P<0.005), pathology (HR 0.834, 95% CI: 0.734–0.948, P<0.005), pathological grade (HR 1.433, 95% CI: 1.164–1.764, P<0.001), surgical treatment (HR 0.778, 95% CI: 0.696–0.870, P<0.000), primary site was excluded (P=0.092). We included all the risk factors from the multi-factor analysis to construct a nomogram, and the C-index value was 0.73, indicating that it was well-calibrated in the medium and long term. Conclusions Laryngeal sarcoma is a rare malignant tumor of the larynx, which most often affects people between the ages of 50 and 79 and males. Our study shows that age, pathology, pathological grade, surgical treatment may be the risk factors for patients’ prognosis. Based on this, we constructed a nomogram model with a prediction accuracy of 73% that could help clinicians make decisions on an individual basis.
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Affiliation(s)
- Jia Gu
- Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Zhifan Zuo
- China Medical University, The General Hospital of Northern Theater Command Training Base for Graduate, Shenyang 110016, China
| | - Lei Sun
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Li Li
- Department of Clinical Nutrition, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China
| | - Ning Zhao
- Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
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Cambruzzi E, Cruz RP, Gava VG, Pêgas KL. Undifferentiated high-grade pleomorphic sarcoma of the larynx treated with partial laringectomy. Braz J Otorhinolaryngol 2016; 86 Suppl 1:14-16. [PMID: 28108272 PMCID: PMC9422573 DOI: 10.1016/j.bjorl.2016.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/18/2016] [Accepted: 11/29/2016] [Indexed: 11/07/2022] Open
Affiliation(s)
- Eduardo Cambruzzi
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Universidade Luterana do Brasil (ULBRA), Porto Alegre, RS, Brazil; Hospital Nossa Senhora da Conceição, Departamento de Patologia, Porto Alegre, RS, Brazil; Santa Casa de Porto Alegre, Departamento de Patologia, Porto Alegre, RS, Brazil.
| | - Ricardo Pedrini Cruz
- Hospital Nossa Senhora da Conceição, Departamento de Oncologia Cirúrgica, Porto Alegre, RS, Brazil
| | - Vinícius Grando Gava
- Hospital Nossa Senhora da Conceição, Departamento de Oncologia Cirúrgica, Porto Alegre, RS, Brazil
| | - Karla Lais Pêgas
- Hospital Nossa Senhora da Conceição, Departamento de Patologia, Porto Alegre, RS, Brazil; Santa Casa de Porto Alegre, Departamento de Patologia, Porto Alegre, RS, Brazil
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Karkos PD, Dova S, Sotiriou S, Markou K, Kostopoulos I. Double primary malignant fibrous histiocytoma and squamous cell carcinoma of the larynx treated with laser laryngeal conservation surgery. Ecancermedicalscience 2016; 10:636. [PMID: 27170836 PMCID: PMC4854225 DOI: 10.3332/ecancer.2016.636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Indexed: 11/06/2022] Open
Abstract
ΒACKGROUND Synchronous multiple malignancies of the larynx are rare. We present a case here of synchronous primary laryngeal squamous cell carcinoma (SCC) and malignant fibrous histiocytoma (MFH) in a patient with hoarseness though with no history of exposure to radiation. Clinical, intraoperative, and histopathological findings in this patient are discussed. METHODS Wide laser excision of the left supraglottic lesion and laser cordectomy of the right true vocal cord were performed. RESULTS The patient presented with a recurrence of the ΜFH alone (with no recurrence of the SCC) two months after the first operation and was managed with an extended second look laser cordectomy. The patient is under regular follow-up and remained disease-free nine months from diagnosis. CONCLUSIONS Our results show that early-stage simultaneous tumours of the larynx and particularly MFH and SCC can be treated efficiently with endoscopic laryngeal surgery alone. Close follow-up is of paramount importance because of the aggressive nature of MFH.
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Affiliation(s)
- P D Karkos
- Department of Otolaryngology-Head Neck Surgery, Ahepa University Hospital, Thessaloniki 546 21, Greece
| | - S Dova
- Department of Otolaryngology-Head Neck Surgery, Ahepa University Hospital, Thessaloniki 546 21, Greece
| | - S Sotiriou
- Department of Histopathology, Aristotle University of Thessaloniki, Thessaloniki 546 21, Greece
| | - K Markou
- Department of Otolaryngology-Head Neck Surgery, Ahepa University Hospital, Thessaloniki 546 21, Greece
| | - I Kostopoulos
- Department of Histopathology, Aristotle University of Thessaloniki, Thessaloniki 546 21, Greece
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