Ancient schwannomas are benign nerve origin neoplasms that may cause difficulties in the differential diagnosis with other benign or malignant tumors. They usually occur in the head and neck region (epiglottis, arytenoepiglottic fold, false vocal cord). Involvement of the true vocal cords is extremely rare (less than 10 cases have ever been reported in the English literature – mainly in women). The present case describes a 27-year-old man who presented with a 2-year history of hoarseness. Indirect laryngoscopy showed a small polypoid mass in the middle of the left vocal cord. During microlaryngoscopy under general anesthesia, the polypoidal mass was removed and sent for histology. Immunohistochemistry and detailed histological examination revealed an ancient schwannoma. The present case in a male patient aims to increase awareness of the possibility that these tumors may also exist in the true vocal cords mimicking other more frequent lesions.
Burkitt’s lymphoma is the most common malignancy in African children but can occur sporadically in every country. It is one of the most aggressive malignancies in the human body, and in the past the prognosis was very poor. However, complex chemotherapy regimens can now cure approximately 50–80% of adult patients with Burkitt’s lymphoma or small noncleaved lymphoma, and in pediatric populations the cure rate is even higher. Although the African type has a preference to the head and neck region (whereas the sporadic type to the abdomen), involvement of the base of the tongue is extremely rare as only 1 case has ever been reported in the English literature. The present study describes a patient with Burkitt’s lymphoma presenting as a single mass in the base of the tongue without any abdominal or other extra-abdominal involvement. The patient was submitted to chemotherapy (intravenous and intrathecal) and skull radiotherapy. Today, 17 months after the diagnosis, the patient is disease free. Physicians should be aware of the extranodal manifestations of Burkitt’s lymphoma and their differential diagnosis in order to achieve early diagnosis and treatment.
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