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表现为双侧声带固定的杓状软骨喉软骨肉瘤:一例报告及文献复习

Laryngeal chondrosarcoma of the arytenoid cartilage presenting as bilateral vocal fold immobility: a case report and literature review.

作者信息

Hu Rong, Xu Wen, Liu Honggang, Chen Xuejun

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

J Voice. 2014 Jan;28(1):129.e13-129.e17. doi: 10.1016/j.jvoice.2013.06.002. Epub 2013 Oct 2.

Abstract

OBJECTIVES

To describe an atypical case of laryngeal chondrosarcoma of arytenoid cartilage presenting as bilateral vocal fold immobility and to avoid potential missed diagnosis.

METHODS

Our case study included a detail history, physical and radiological examination, laryngeal electromyography (LEMG), and surgical treatment and pathology analysis. We compared it with the previously discussed cases of chondrosarcoma of arytenoid cartilage in the literature.

RESULTS

Chondrosarcomas of the arytenoid cartilage is rare, and to date only approximately 10 cases have been reported. We reported a case of a 51-year-old man with 1 month of persistent dyspnea presenting with bilateral vocal fold immobility without neoplasms in larynx. The LEMG showed no obvious abnormality. The cervical-enhanced computed tomography (CT) found no significant signs of a mass except for localized high-density areas in arytenoid cartilage. Right arytenoidectomy and biopsy were performed under general anesthesia with CO2 laser with the pathological diagnosis of chondroma. A total laryngectomy was performed 2 years later, and low-grade chondrosarcoma was the final diagnosis.

CONCLUSIONS

Laryngeal chondrosarcomas of the arytenoid cartilage are rare. It is easily neglected, especially in those cases presenting with idiopathic vocal fold immobility without any obvious signs of neoplasms. The LEMG and laryngeal CT are necessary. Sometimes, a biopsy of the arytenoid cartilage is essential.

摘要

目的

描述一例以双侧声带固定为表现的杓状软骨喉软骨肉瘤的非典型病例,以避免潜在的漏诊。

方法

我们的病例研究包括详细的病史、体格检查和影像学检查、喉肌电图(LEMG)、手术治疗及病理分析。我们将其与文献中先前讨论的杓状软骨软骨肉瘤病例进行了比较。

结果

杓状软骨软骨肉瘤罕见,迄今为止仅报道了约10例。我们报告了一例51岁男性,持续呼吸困难1个月,表现为双侧声带固定,喉部无肿瘤。喉肌电图显示无明显异常。颈部增强计算机断层扫描(CT)除杓状软骨局部高密度区外,未发现明显肿块迹象。在全身麻醉下用二氧化碳激光行右侧杓状软骨切除术及活检,病理诊断为软骨瘤。2年后行全喉切除术,最终诊断为低级别软骨肉瘤。

结论

杓状软骨喉软骨肉瘤罕见。它很容易被忽视,尤其是在那些表现为特发性声带固定且无任何明显肿瘤迹象的病例中。喉肌电图和喉部CT是必要的。有时,杓状软骨活检至关重要。

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