Leiomyosarcoma of the Tracheostomy Site in a Patient with History of Laryngeal Squamous Cell Carcinoma

Abstract

Leiomyosarcoma (LMS) of the trachea is an extremely rare malignancy with only a few reported cases in English literature. As such the diagnosis can be frequently missed or delayed. We present a case of a 69-year-old male who underwent tracheostomy for airway obstruction secondary to glottic squamous cell carcinoma and treated definitely with radiation therapy. Subsequently, the patient developed LMS of the tracheostomy site. The case further details multiple risk factors that could contribute to development of LMS including radiation exposure, prior malignancy, and chronic inflammation. These risk factors have been well established for LMS in other sites but less so in the head and neck region, which is the subject of our discussion. We also review the current guidelines for head and neck as well as limb sarcomas and discussed role of surgery or radiation and their accompanying challenges in management of this rare malignancy.

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

“…In the larynx, only blood vessels have smooth muscle tissue, and tumors typically develop from smooth muscle in the tunica media of vessel walls. There are five competing hypotheses on the pathogenesis of LLMS 15,44,47,53,99,100 . It can develop primarily from smooth muscle in the tunica media of vessel walls.…”

“…There are five competing hypotheses on the pathogenesis of LLMS. 15 , 44 , 47 , 53 , 99 , 100 It can develop primarily from smooth muscle in the tunica media of vessel walls. Metastases from LMS in other sites can invade the larynx.…”