Metastatic Cancer to the Larynx: A Case Report and Update

Zenga, Joseph; Mehrad, Mitra; Bradley, Joseph P.

doi:10.1016/j.jvoice.2015.11.017

Cited by 17 publications

(30 citation statements)

References 41 publications

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“…The signs and symptoms of metastatic laryngeal lesions are similar to those of primary laryngeal malignancies, including hoarseness, stridor and dyspnea. Tracheostomy can be performed in those with respiratory distress where the tumor is compromising their airway, but in our case, the patient was asymptomatic allowing this to be avoided [4]. The mechanism of spread from tongue to subglottis in this case is difficult to identify, but there are various routes by which this could have occurred.…”

Section: Case Reportmentioning

confidence: 84%

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Subglottic Metastasis of Adenoid Cystic Carcinoma from an Anterior Tangue Primary

Heyes¹,

Balakumar²,

Tadrous³

et al. 2017

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A 69-year-old lady, whose clinical course included previous pulmonary and cutaneous metastases, presented six years subsequent to primary excision and radiotherapy for left anterior tongue adenoid cystic carcinoma. Computed tomography neck, chest, and abdomen performed for pulmonary metastatic monitoring, incidentally detected a subglottic soft tissue swelling. Microlaryngoscopy and carbon dioxide laser excision completely removed this subglottic polypoidal mass. Histology confirmed respiratory-type mucosa invaded and ulcerated by adenoid cystic carcinoma with perineural invasion. Adenoid cystic carcinoma is locally invasive and only accounts for 1% of all head and neck malignancies. Hematogenous spread to lung, bone and liver are common, conversely regional lymph node metastases are rare. Despite this, due to the proximity of the primary and metastasis, the complex lymphatic connection between these sites may play a crucial role in this case.

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Section: Case Reportmentioning

confidence: 84%

“…Metastatic tumors to the larynx are rare and account for 0.1 to 0.4% of all laryngeal tumors [4]. The most common primary sites are cutaneous melanoma and renal cell carcinoma, with colorectal adenocarcinoma metastasis increasingly reported.…”

Section: Case Reportmentioning

confidence: 99%

Subglottic Metastasis of Adenoid Cystic Carcinoma from an Anterior Tangue Primary

Heyes¹,

Balakumar²,

Tadrous³

et al. 2017

JOENTR

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“…Ferlito et al reported in 1988 that the most common primary sites for these metastases are the skin (melanoma) and the kidney (renal cell carcinoma); a recently published review of the English literature since 1988 proposes that colorectal adenocarcinoma is more common than previously anticipated, accounting for a quarter of 41 published cases [3, 4]. …”

Section: Discussionmentioning

confidence: 99%

“…The location prevalence of metastatic tumors of the larynx is as follows: 39% transglottic, 27% supraglottic, 27% subglottic, and 7% glottic [4]. The site of laryngeal metastasis of colorectal adenocarcinoma is known for 14 patients: 50% were subglottic, 21% transglottic, 14% supraglottic, and 7% glottic [8].…”

Section: Discussionmentioning

confidence: 99%

“…The site of laryngeal metastasis of colorectal adenocarcinoma is known for 14 patients: 50% were subglottic, 21% transglottic, 14% supraglottic, and 7% glottic [8]. The median age of laryngeal metastasis presentation is 59 years with a male predominance [4]. The symptoms of laryngeal metastases resemble the symptoms of primary laryngeal tumors.…”

Section: Discussionmentioning

confidence: 99%

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Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome

Heyes

Balakumar

Ramdoo

et al. 2017

Case Reports in Otolaryngology

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A 56-year-old female with a background of metastatic rectal adenocarcinoma presented with a subglottic mass causing biphasic stridor. Transoral laser microsurgery and the use of fibrin glue prevented the need for tracheostomy. Six months postoperatively there was no evidence of recurrence. Laryngeal metastasis of colorectal adenocarcinoma, although remarkably rare, is perhaps more prevalent than commonly perceived and the presence of laryngeal symptoms in a patient with colorectal adenocarcinoma should raise concern. This case is presented to aid physicians should they encounter a similar presentation of metastasis to the subglottis.

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Posterior Subglottic Mass in a Patient With a History of Rectal Adenocarcinoma and Lung Metastases

2020

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The patient is a 48-year-old man with a history of a rectal adenocarcinoma (cT3N2bM0) diagnosed 9 years prior. Following neoadjuvant chemoradiotherapy, low anterior resection, and 6 cycles of adjuvant FOLFOX therapy (fluorouracil, leucovorin, and oxaliplatin), he had developed a lung metastasis (KRAS wild type) 1 year later. He subsequently developed multiple lung metastases treated with palliative local interventions (lobectomy, radiofrequency ablation) and 4 lines of chemotherapy. Owing to symptomatic lung disease, he was enrolled in a clinical trial (NCT03502733) following informed consent and achieved a confirmed partial response. After 9 months, contrast computed tomography restaging scans noted a new, 1-cm posterior subglottic lesion of unclear origin (Figure , A). He had no shortness of breath or noisy breathing, dysphagia, voice change, or hemoptysis. A partial response was maintained without evidence of progression of lung disease.Otolaryngology was consulted to assess the lesion. The differential diagnosis based on imaging included a mass vs inspissated mucus. Examination using distal-chip flexible laryngoscopy revealed a 1-cm, broad-based, exophytic mass along the posterior wall of the subglottis with prominent vasculature. No other anatomic abnormalities in the upper aerodigestive tract or cervical lymphadenopathy were noted. The decision was made to proceed to the operating room for definitive endoscopic biopsy under general anesthesia (Figure , B). Examination revealed a subglottic mass that did not extend inferiorly beyond the caudal aspect of the cricoid cartilage. The mass was debulked and sent to pathology for analysis, including hematoxylin-eosin and immunohistochemical staining (Figure , C).

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Metastatic Cancer to the Larynx: A Case Report and Update

Cited by 17 publications

References 41 publications

Subglottic Metastasis of Adenoid Cystic Carcinoma from an Anterior Tangue Primary

Subglottic Metastasis of Adenoid Cystic Carcinoma from an Anterior Tangue Primary

Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome

Posterior Subglottic Mass in a Patient With a History of Rectal Adenocarcinoma and Lung Metastases

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