Osteosarcoma of the soft tissue of the larynx. Report of a case with light and electron microscopic studies

Abstract

A case of osteosarcoma arising in the soft tissue of the larynx in an elderly man is presented with light and electron microscopic documentation. The patient developed chronic hoarseness and a recurring polypoid laryngeal tumor, causing acute airway obstruction. He was treated by total laryngectomy, but he died with multiple pulmonary metastases within three months of laryngectomy. This is the third (or possibly fourth) recorded case of osteosarcoma arising in the soft tissues of the larynx, and the previous cases were clinically and pathologically similar to this one. The prognosis of sarcoma of the larynx is poor but may be improved with early recognition and adequate surgical excision.Cancer 42:2343-2351, 1978.ARCOMAS OF THE LARYNX a r e relatively S uncommon. They have been estimated to comprise between 0.32%13 a n d 1 or 2%2,3310 of all laryngeal neoplasms. Batsakis a n d Fox state that less than half of the nonepithelial lesions of the larynx are malignant. Based o n the frequency of reported cases, fibrosarcoma and chondrosarcoma a r e the most frequent primary sarcomas in the larynx, a n d most of the others are examples of lymphosarcoma a n d angiosarcoma. T h e r e a r e two accepted cases of primary osteosarcoma of the l a r y n~'~,~~ and a third case which may be a primary osteosarcoma.'j This report describes an osteosarcoma arising in the soft tissue of the larynx. CASE REPORTA 79-year-old white male retired farmer was first seen at Parkland Memorial Hospital by the Otolaryngology Department on November 15, 1976 complaining of recurrent hoarseness, a sensation of "a lump in the throat," and marked difficulty breathing. He noted the onset of the first two symptoms in March 1976 and had undergone four previous laryngeal biopsies for what was reported to be a pyogenic granuloma. The last biopsy was performed three weeks prior to admission to Parkland Memorial Hospital. The patient had known cardiac disease with exertional angina and ischemic electrocardiographic changes, adult onset diabetes mellitus of unknown duration, and hypertension, treated by diuretics since 1969.The patient had a 40 pack-year history of cigarette smoking, having quit smoking in 1960. There was no known exposure to asbestos, toxic fumes or other carcinogenic substances.On admission his blood pressure was 172/92, pulse 84 and respiratory rate 20. The patient was alert and cooperative. There was no cervical lymphadenopathy and the trachea was in the midline. The chest was clear to percussion and auscultation; breath sounds were decreased. Cardiac examination showed a Grade III/VI holosystolic murmur, and roentgenogram of the chest showed mild cardiomegaly .The day following admission, the patient developed acute airway obstruction and tracheostomy was performed (Fig. 1). Direct laryngoscopy on the fourth day of hospitalization showed an exophytic mass covered by mucosa at the anterior commissure with involvement of the immediate infraglottic area, more so on the right than the left. The bulk of the mass was removed from the righ...

Staging and Survival Analysis for Nonsquamous Cell Carcinomas of the Larynx

“…Soft tissue tumors of the larynx are rare, accounting for less than 2% of all laryngeal neoplasms, and, of these cases, less than half are malignant. 17 Many of these malignancies are considered low grade and exhibit relatively favorable cure rates. Nevertheless, we found our 5-year survival estimate for sarcoma in the supraglottic larynx to be low, at 17.5%.…”

A Review of Primary Osteosarcoma of the Larynx and Case Report

“…An extensive Pubmed search resulted in only 25 published cases of primary laryngeal osteosarcoma. The mean age at presentation was 63.5 years, with an age range of 51-80 years (Table 1) [1,[5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. In the reported cases (including the present case), only two cases occurred in females, with a male: female ratio of 13:1 (Table 1).…”

Laryngeal osteosarcoma: Case report and literature review

“…Osteosarcoma of the larynx is extremely rare and demonstrates many differences from osteosarcoma of other head and neck sites. Only 24 cases of laryngeal osteosarcoma were reported from 1942 to 2009 (Table ), excluding 2 patients who were not described in detail and were lost to follow‐up shortly after surgery. Among these 24 cases, the median age at diagnosis was 64 years (range, 47–80 years), and most patients were men (92%).…”

“…Sarcomas of the larynx are uncommon tumors. They comprise about 1% of all malignant laryngeal tumors, and osteosarcomas are extremely rare . Only 24 cases of osteosarcoma of the larynx have been reported.…”