Adenoid cystic carcinoma is one of the rare pathological conditions affecting the larynx. It is known to develop from the glandula elements present in this organ. The authors report a clinical observation of adenoid cystic carcinoma in the form of an exophytic tumour of the pale pink colour having a smooth surface and the well-pronounced vascular patterns at the base. The neoplasm is localized in the arytenoid and retroarytenoid cartilage regions. Being of 3.5-4 cm in size, the tumour causes the narrowing of the larynx in its posterior portions and restricts its mobility. Bearing in mind the considerable extension of the neoplastic process, we undertook laryngectomy including the resection of the orolaryngopharynx and the cervical portion of the oesophagus, the subtotal resection of the thyroid gland and the simultaneous reconstruction of the orolaryngopharynx.
This review discusses current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx. It describes different variants of surgical treatment, radiotherapy, combination therapy, endotracheal interventions using endoscopic techniques and physical methods, grafting, tracheal transplantation, complications, and oncological and functional treatment outcomes. We also analyze clinical aspects of adenoid cystic carcinoma of the larynx, most common tumor location, difficulties associated with morphological verification, and controversial issues related to surgery volume, considering that this disease is rare and clinical experience is often insufficient.
The objective is to report a rare case of laryngeal cancer in spouses. Case report. A 59-year-old female patient was admitted to the Department of Head and Neck Tumors in December 2019 with complaints of hoarseness. In 1997, she had radiotherapy for T1N0M0 laryngeal cancer. After comprehensive examination, she was diagnosed with recurrent laryngeal cancer. The patient has undergone frontolateral laryngeal resection. A 67-year-old male patient was admitted to the Department of Head and Neck Tumors in November 2019 with T3N0M0 laryngeal cancer (diagnosed 2 months before). He has undergone extended frontolateral laryngeal resection followed by radiotherapy in the postoperative period. Discussion. Both patients had no risk factors, such as occupational hazards or smoking. However, both spouses had close relatives with cancer, what indicates their genetic predisposition to malignant tumors. The female patient was found to have human papilloma virus (HPV) in the tumor cells, whereas her spouse was HPV-negative, although rapid histology showed indirect signs of HPV, which does not exclude the elimination of HPV. Conclusion. In this rare case of laryngeal cancer diagnosed in two non-consanguineous spouses, the disease is likely to be caused by their hereditary predisposition, HPV infection, and the fact that they lived in the same socioeconomic conditions.
Рак гортани занимает ведущее место в структуре онкологической заболеваемости верхних дыхательных путей и составляет 50-70% по данным разных авторов. Несмотря на широкие возможности ранней диагностики, большинство больных (60-70%) обращаются за медицинской помощью на III и IV стадиях заболевания [1-5]. Основным видом лечения распространенных опухолей гортани является ларингэктомия, которая приводит к потере голоса. Реабилитация голосовой функции после этой операции возможна несколькими путями: обучение пищеводному голосу, использование голосообразующих аппаратов, применение различных видов реконструктивных операций. Хирургические реконструктивные вмешательства выполняются в следующих вариантах: ларингэктомия с формированием трахеопищеводного шунта за счет аутотканей и ларингэктомия с трахеопищеводным шунтированием и эндопротезированием. В настоящее время одним из важнейших направлений хирургических методов восстановления голоса после удаления гортани является трахеопищеводное шунтирование с эндопротезированием [1, 3-13]. По данным разных авторов, средний срок эксплуатации голосовых протезов составляет 6-12 мес [2, 4, 7, 11, 13, 14]. Длительная 11-летняя эксплуатация отечественного голосового протеза у больного после ларингэктомии с трахеопищеводным шунтированием и эндопротезированием послужила причиной нашего сообщения. Больной М., 54 лет, поступил в отделение опухолей головы и шеи ОКД №1 ДЗ Москвы 18.
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