Double primary malignant fibrous histiocytoma and squamous cell carcinoma of the larynx treated with laser laryngeal conservation surgery

Abstract

ΒackgroundSynchronous 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.MethodsWide laser excision of the left supraglottic lesion and laser cordectomy of the right true vocal cord were performed.ResultsThe 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.ConclusionsOur 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.

Extremely rare primary undifferentiated pleomorphic thyroid sarcoma-Clinical case with a literary review

“…Pleomorphic areas contain plumper fibroblastic cells, rounded histiocyte-like cells arranged haphazardly with no particular orientation to vessels, and a large number of giant cells with multiple hyperchromatic irregular nuclei [36]. Most tumors www.medclinres.org have a combination of storiform and pleomorphic areas, with preponderance on the latter, which also exhibit more accentuated pleomorphism and mitotic activity [34,37,38]. In the clinical case presented, it is observed admixture of pleomorphic and storiform areas with sheets of polygonal, spindled and epithelioid cells, abundant eosinophilic cytoplasm, marked nuclear pleomorphism, necrosis, epithelioid cells with typical and atypical mitotic activity, chains of atypical spindle cells, resembling blood vessels (Figure 3 and Figure 4).…”

Malignant fibrous histiocytoma of the right upper leg: A case report

“…The presence of immunohistochemical marker, bone morphogenic protein 2, gives better prognosis for patients 27 . Focal or weak immunoreactivity to mesenchymal markers such as CD10, CD99, CD68, lysozyme, fascin, and other intermediated filaments like desmin and neurofilaments has already been observed in cases of MFH 5 .…”

“…Malignant fibrous histiocytoma (MFH) is a most common type of soft tissue sarcomas (STS), that was originally described by Ozzello et al 1 most frequently during the sixth and seventh decades of life 4 . Localisation regarding on the region of the body is as follows: over 70% of cases are located on extremities (50% on lower, and 25% on upper), followed by retroperitoneum (15%), and head and neck in 3-10% 5 . Rare cases include almost every organ in the body -bones, lungs, intestine, greater omentum, scars after surgical incision or even retained gauze 6 .…”

Radiation-Associated Laryngeal Malignant Fibrous Histiocytoma

“…Chien-Fu Lin, MD 1 , Yi-Shing Leu, MD 1,2 , and Dao-Yuan Wang, MD 3 A 54-year-old man who was a nonsmoker presented at our ear, nose, and throat (ENT) clinic complaining of progressive hoarseness for the preceding 3 months. Fiberscopy revealed a 2 mm  2 mm right-false vocal fold nodular lesion ( Figure 1A).…”

“…In cases of MFH, IHC staining is typically positive for mesenchymal markers (eg, vimentin and smooth muscle actin) and negative for epithelial markers (eg, cytokeratin 5/6 and cytokeratin AE1/AE3). 3 Conversely, in cases of SCC, IHC staining yields opposing results. Approximately 3% of all cases of MFH arise at the site of previous radiotherapy and are considered to be radiationassociated sarcoma (RAS).…”