Inflammatory myofibroblastic tumor in the larynx: clinicopathologic features and histogenesis

Abstract

Inflammatory myofibroblastic tumor is extremely rare in the larynx and can mimic a malignant process. We present the case of a 62-year-old male who required tracheotomy due to rapidly progressive stridor. Laryngoscopy showed an exophytic, occlusive tumor located in the right true vocal cord. CT showed an expansive mass measuring 2 x2 x1.3 cm3 and occupying the anterior commissure, with glottic progression to the right true vocal cord. The tumor was completely resected with a CO2 laser via a transoral approach. Histologic examination demonstrated extensive ulceration with the presence of granulation tissue. The specimen was mainly composed of spindle cells arranged in a fasciculated pattern with a myxoid background and focal hyalinization. Immunohistochemical studies revealed positivity of spindle cells to vimentin, muscle-specific actin and smooth muscle actin. The patient showed no evidence of disease 24 months after surgery.

Spindle Cell Lesions—Neoplastic or Non-Neoplastic?

“…The head and neck is a relatively uncommon site, particularly if one considers mucosal-based lesions. There are 19 reported cases in the larynx [23,24], making it the most common head and neck site. Other reported sites include the oral cavity, nasal cavity and paranasal sinuses, and tonsil.…”

Tumor miofibroblástico inflamatório: caso raro em laringe

“…Guilemany et al 2 reported 11 cases in adults aged from 19 to 74 years (8 male and 3 female). Four cases were reported in children 4,5 aged from 5 to 11 years (3 male and 1 female).…”

“…Guilemany et al 2 described the first case in the larynx with systemic manifestations -fever, anemia, thrombocytosis and altered erythrocyte sediment. The patient in another reported case1 had ossifying myositis.…”

“…1,2 The paranasal sinuses and the orbit are the most affected areas in the head and neck; the laryngeal presentation is extremely rare, and only about 15 cases have been described in the literature. We report the clinical findings of a case of laryngeal IMT that was seen at the otorhinolaryngology unit of a university hospital.…”

Inflammatory Myofibroblastic Tumor of the Larynx: Report of a Rare Case and Literature Review

“…The male-female ratio was 1.8 t0 1. They also found that the relapse rate was 21% and most of the cases in the first year after surgery [18][19][20][21].…”