Laryngeal leiomyosarcoma masquerading as laryngeal carcinoma

Abstract

Laryngeal leiomyosarcoma is an exceedingly rare malignant tumour, with fewer than 50 reported cases in scientific literature. Diagnosis is based on immunohistochemistry, supplemented with ultrastructural studies, if required. It is aggressive and associated with variable survival outcomes. A 63-year-old man presented with hoarseness for 7 months and breathlessness for 3 months. Imaging showed a well-defined 3 cm glottic mass. Total laryngectomy was performed. The histopathological examination showed features of leiomyosarcoma. The index case has been presented owing to its rarity, variable clinical manifestations and diagnostic dilemmas and to stress upon the importance of ancillary techniques for confirmation.

Epstein–Barrvirus‐associated leiomyosarcoma of the larynx in an adult patient with human immunodeficiency virus infection: Case report and review of the literature

“…LLMS is uncommon; we identified 62 cases in the English‐language literature (Table 1). 1,3–55 Tangjaturonrasme found that the number of LLMS cases was increasing; four cases were reported from 1961 to 1970, compared to 21 cases from 2000 to 2010. This may be a result of advances in diagnostic techniques, including immunohistochemical techniques and electron microscopy 46 .…”

“…Most patients had overlapping presentations: 8 of 61 (13.1%) had hoarseness and dyspnea, and 14 of 61 (23.0%) had hoarseness/stridor/dyspnea/dysphagia. Ten of sixty‐one patients (16.4%) had emergency tracheostomy for serious dyspnea 14,17,28,33,35,39,43,46,47,53 . The laryngoscopic manifestations of LLMS are diverse.…”

“…It was first reported by Jackson and Jackson in 1939 2 . To the best of our knowledge, 62 cases of LLMS have been reported in the English‐language literature 1,3–55 …”

“…Factors predisposing to LLMS include radiation exposure, surgery, multiple basal cell carcinoma syndrome, Gardner syndrome, tuberous sclerosis, neurofibromatosis, Werner syndrome, retinoblastoma, Turcot syndrome, and Epstein–Barr virus (EBV) infection in immunosuppressed patients 1,3–55 …”

“…2 To the best of our knowledge, 62 cases of LLMS have been reported in the English‐language literature. 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 …”