Laryngeal cancer after topical mitomycin C application

Abstract

Mitomycin C is part of the mitomycin group of antibiotics and has found use in medicine in the treatment of various cancers, including those of the head and neck. In recent years, it has gained popularity as a topical treatment to prevent scar formation in the larynx and choanae in paediatric and adult inflammatory processes. Also, this alkylating agent is potentially a potent carcinogen. We report the first case in the world literature of laryngeal carcinoma in a non-smoking adult, which may have been induced by topical mitomycin C application to a glottic web. We discuss the mechanism of action of this drug, and we advise caution on its use for benign laryngeal pathologies.

Topical use of MMC in the upper aerodigestive tract: a review on the side effects

“…Agrawal and Morrison wrote a case report about a 57-year-old non-smoking and non-drinking male with a long history of chronic laryngitis with the removal of a polyp and keratosis (left vocal fold) [11]. Laryngoscopy showed a web at the anterior commissure.…”

“…After 2.5 years, a T1aN0M0 squamous cell carcinoma on the right vocal fold developed. The carcinoma was locally resected and subsequent radiotherapy followed [11]. …”

“…Agrawal and Morrison reported a patient with potentially MMC related laryngeal carcinoma in a non-smoking adult [11]. The chance for this patient of developing laryngeal cancer is around 8.8 per 100,000 [53].…”

Morbidity and mortality associated with subglottic laryngotracheal stenosis in granulomatosis with polyangiitis (Wegener's granulomatosis): a single-centre experience in the United Kingdom

“…Subglottic laryngotracheal stenosis has been found to occur in approximately [16][17][18][19][20][21][22][23] per cent of patients with granulomatosis with polyangiitis. Subglottic laryngotracheal stenosis has been found to occur in approximately [16][17][18][19][20][21][22][23] per cent of patients with granulomatosis with polyangiitis.…”

Choanal Atresia

“…Mitomycin C is an anti-proliferative agent that inhibits fibroblast growth and proliferation, and is sometimes used to try and prevent scar tissue and granulation formation after choanal atresia surgery [47,48]. Furthermore, there are long term concerns about the application of a potentially oncogenic medication in a small child for a benign condition [50]. After initial enthusiasm, there has been a number of case series that show no convincing effect of mitomycin on the long term success rates, although no randomized trial has been performed [8,31,49].…”