Kollert M, Basten O, Delling G, Bockmühl U
Klinik für HNO-Krankheiten, Kopf-, Hals- und Plastische Gesichtschirurgie und Kommunikationsstörungen, Klinikum Fulda.
HNO. 2005 Apr;53(4):357-60. doi: 10.1007/s00106-004-1089-x.
Clear cell chondrosarcoma is a rare bone tumor of low malignancy. It constitutes only 2% of all chondrosarcomas and shows a particular predilection for the epiphyses of long bones. So far, there have only been three cases of clear cell chondrosarcoma of the larynx published in the literature. We report the case of a 46 year old man who suffered from slowly worsening dyspnoea. Diagnostic evaluation revealed a directly subglottic stenosis of the larynx, narrowing the lumen to 1/3. When we tried to resect the stenosis via splitting the ring cartilage from outside, tumorous infiltration of the whole ring cartilage was found. Extended biopsies were taken and histology revealed a clear cell chondrosarcoma. The therapy of choice for this tumor is wide surgical resection. Additional radio- and/or chemotherapy are not recommended. Therefore, the patient underwent laryngectomy. Histologically, the clear cell chondrosarcoma can be easily confused with the highly malignant osteosarcoma or the conventional chondrosarcoma, both requiring more aggressive treatment. Thus, clear cell chondrosarcoma should be kept in mind and, when necessary, a reference histology by a bone tumor register should be requested.
透明细胞软骨肉瘤是一种罕见的低恶性骨肿瘤。它仅占所有软骨肉瘤的2%,并且特别好发于长骨的骨骺。迄今为止,文献中仅报道过3例喉透明细胞软骨肉瘤。我们报告一例46岁男性患者,其患有逐渐加重的呼吸困难。诊断评估显示喉部直接位于声门下的狭窄,管腔缩小至原来的1/3。当我们试图通过从外部劈开环状软骨来切除狭窄时,发现整个环状软骨均有肿瘤浸润。进行了扩大活检,组织学检查显示为透明细胞软骨肉瘤。该肿瘤的首选治疗方法是广泛手术切除。不建议进行额外的放疗和/或化疗。因此,该患者接受了喉切除术。在组织学上,透明细胞软骨肉瘤很容易与高恶性骨肉瘤或传统软骨肉瘤混淆,而后两者都需要更积极的治疗。因此,应牢记透明细胞软骨肉瘤,必要时应向骨肿瘤登记处请求参考组织学诊断。