Mesolella M, Motta G, Galli V
Department of Otolaryngology, University School of Medicine Federico II Naples, Italy.
Acta Otorhinolaryngol Belg. 2004;58(1):73-8.
Chondrosarcoma of the larynx is a rare slow-growing malignant tumour with approximately 240 cases reported in the literature: the cricoid cartilage is the most commonly affected site (72-75%), in rare case was described of epiglottis (1-2%). We report a case of a chondrosarcoma of the epiglottis treated with CO2 laser epiglottectomy. The patient was referred with dysphonia, dysphagia and halitosis that started four months before. Indirect laryngoscopy revealed a large smooth mass with a roundish appearance and a pearly-grey colour, as big as a nut, apparently arising from the laryngeal surface of the epiglottis, causing obliteration of the piriform fossa. The definitive histopathological report showed microscopically, the tumour was low-grade (grade I) chondrosarcoma. A literature review regarding chondrosarcomas of the epiglottis is presented. The diagnosis, histology and treatment of these tumours are discussed. In particular we examine the controversy of conservative surgery vs. total laryngectomy. A conservative surgical approach is typically appropriate in light of this tumour's low-aggressive nature.
喉软骨肉瘤是一种罕见的生长缓慢的恶性肿瘤，文献报道约240例：环状软骨是最常受累部位（72 - 75%），罕见累及会厌（1 - 2%）。我们报告1例会厌软骨肉瘤患者，接受二氧化碳激光会厌切除术治疗。该患者因四个月前开始出现的声音嘶哑、吞咽困难和口臭前来就诊。间接喉镜检查发现一个大的光滑肿物，呈圆形，珍珠灰色，大小如坚果，明显起源于会厌的喉面，导致梨状窝闭塞。最终的组织病理学报告显示，显微镜下该肿瘤为低级别（I级）软骨肉瘤。本文对会厌软骨肉瘤进行了文献综述，并讨论了这些肿瘤的诊断、组织学和治疗方法。特别是我们探讨了保守手术与全喉切除术之间的争议。鉴于该肿瘤侵袭性低的特点，保守手术方法通常是合适的。
