Laryngeal granuloma occurring after surgery for laryngeal cancer treated by surgical removal and immediate post-operative radiotherapy

Abstract

Rational:Laryngeal granulomas are benign lesion that rarely occurs after surgery of laryngeal cancer. Until now there has not been standard treatment for it.Patient concern:The patient was diagnosed with laryngeal neoplasm one and half a month ago. Endoscopic low-temperature plasma knife in the radical excision of left vocal cord was performed under the general anesthesia. Postoperative histopathological examination confirmed left vocal cord tumor was highly differentiated invasive squamous cell carcinoma (SCC). Then the patient suffered unexplained intermittent dyspnea which persisted nearly 1 month after the surgery. Laryngoscope examination showed granulation formation on the glottis.Diagnoses:The patient was diagnosed with laryngeal granuloma 1 month after the surgery of laryngeal cancer.Interventions:The patient received resection of the laryngeal mass, and pathological examination confirmed the granuloma. Postoperative radiotherapy (RT) was performed within 24 hours after surgery.Outcomes:The patient was followed up for 3 years after surgery and the laryngeal granuloma and laryngeal cancer did not recur during follow-up. The symptoms of intermittent dyspnea disappeared and a satisfactory outcome was achieved.Lessons:Usually for primary laryngeal granulomas, surgical treatment alone is not enough, because it is easy to relapse. RT within 24 hours after operation can significantly reduce the recurrence of laryngeal granuloma.

Application of local flipped pedicle microflap combined with botulinum toxin A injection in the treatment of refractory laryngeal contact granuloma

“…An recent study indicate that The initial non-surgical treatment (67 percent) has a much higher cure rate than surgical treatment (30 percent) in contact granuloma patients 9 . Jingyi Wu reported that given postoperative radiotherapy within 24 hours can reduce the recurrence of laryngeal granuloma effectively 15 . Vojko Djukic have studied that Zinc supplementation for the treatment of granuloma of the larynx is one of the conservative treatment 16 .…”

Fatal asphyxia due to large laryngeal granuloma

“…In a PubMed search, we found one case after laryngeal neoplasm operation, 7 two cases after vocal abuse/gastro-oesophageal reflux, 8 one systemic review of post-intubation laryngeal granulomas of 85 patients. 9 Our case is the first reported case of death due to glottic granuloma occurring after several surgical procedures for laryngeal polyp resection.…”

“…As these lesions age, granulation tissue may be initially replaced by fibrosis and finally by hyperplasia of the superficial squamous epithelium. 7 , 12 , 19 …”