Laryngeal Giant Cell Tumor: A Case Report and Review of the Literature

Abstract

Giant cell tumor (GCT) is a benign neoplasm arising most commonly in the long bones. GCTs of the larynx (GCTL) are relatively rare, and only individual case reports are documented in the literature. Patients with such tumors may present with hoarseness and anterior neck swelling. We present a 59-year-old man with hoarseness and enlarging anterior neck mass for 3 months. A fiberscopy revealed a submucosal swelling of the left subglottic trachea. Computed tomography and magnetic resonance imaging of the larynx demonstrated a large, well-defined, inhomogeneous enhancing mass at the left thyroid cartilage, which was obstructed entirely. The anterior neck mass was biopsied for histopathological analysis, which showed multinodularity with intervening vascularized connective tissues. The mass was made up of mononuclear cells and distributed multinucleated giant cells. The mitotic activity of the mononuclear cells was as high as 6 per 10 high-power fields. Pathologic consultation resulted in a diagnosis of giant cell tumor. The patient underwent total laryngectomy and, postoperatively, he did well without recurrence or metastasis for two and a half years.

Giant Cell Tumor of the Larynx Treated by Surgery and Adjuvant Denosumab: Case Report and Review of the Literature

“…The first case of GCTL was reported by Wesely in 1940 [5][6][7][8]. Since then a total of 33 additional cases have been published [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…Of the laryngeal structures, the thyroid cartilage is the most common site of origin (21, 60 %), followed by the cricoid cartilage (9, 26 %), the epiglottis (2, 6 %) and the soft tissues of the larynx (2, 6 %) [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The location of one case was not specified [5][6][7][8] (Table 1).…”

“…Four authors reported normal laboratory values for serum calcium and three reported normal alkaline phosphatase levels, two of which also reported normal levels of parathyroid hormone. In eleven cases a history of tobacco use was elicited and was denied by all [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The treatment modality was described in 32 of the 34 cases [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…The majority of cases were treated by surgery alone (19, 56 %), ranging from local excision to total laryngectomy. Eight cases were treated by surgery and radiation (24 %), three by radiation alone (9 %) and one case by surgery, radiation and chemo therapy (3 %) [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Derbel et al [18] recently reported the use of denosumab following surgery in treating a single case of GCTL (3 %).…”

“…While two authors reported thyroid gland displacement by the tumor [10,18], there were no reports of infiltration of the thyroid gland. Thirty-one cases involved the cartilaginous structures of the larynx, two cases occurred in the soft tissues and one case occurred in an unspecified location [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. It was reported that bone was identified in the microscopic specimens of twelve cases [5-9, 11-14, 16, 18].…”