Karatayli-Ozgursoy S, Bishop J A, Hillel A T, Akst L M, Best S R
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Otolaryngolgy, Ufuk University, Ankara, Turkey.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Am J Otolaryngol. 2016 May-Jun;37(3):279-85. doi: 10.1016/j.amjoto.2016.01.005. Epub 2016 Jan 27.
Non-epithelial tumors of the larynx are rare and encompass a wide range of pathology. We present the decade-long experience of a single institution to define clinical presentations and outcomes.
This is a ten year retrospective chart review of a tertiary head and neck cancer center. Index patients were identified from a review of a pathology database, and patient demographics, presenting signs and symptoms, treatment modalities, and clinical outcomes were extracted from electronic medical records. Epithelial tumors (squamous cell carcinoma, spindle cell carcinoma, and salivary tumors), granulomas, sarcoidosis, papilloma, and amyloidosis were all excluded.
Twenty-four patients with ages ranging from 2months-old to 84years were identified. Malignant lesions (11) included chondrosarcoma (6), Kaposi's sarcoma (2), metastatic melanoma, synovial cell sarcoma, and T cell neoplasm. Six were operated upon endolaryngeally, but four required either upfront or salvage total laryngectomy. Two received adjuvant therapy. Benign lesions (13) included hemangioma (4), granular cell tumor (3), myofibroblastic tumor (2), schwannoma (2), chondroma, and ossifying fibromyxoid tumor. Nine underwent endolaryngeal operations, and four were managed medically or with observation. None have required aggressive open resection or total laryngectomy.
Treatment approach of non-epithelial tumors of the larynx depends on the site and extent of the tumor, histology, and sensitivity of adjuvant therapy. Benign tumors can be managed without need for aggressive resection thereby sparing laryngeal function.
喉非上皮性肿瘤罕见,涵盖多种病理类型。我们介绍一家机构长达十年的经验,以明确临床表现和治疗结果。
这是对一家三级头颈癌中心进行的十年回顾性病历审查。通过查阅病理数据库确定索引患者,并从电子病历中提取患者人口统计学信息、临床表现和症状、治疗方式及临床结果。上皮性肿瘤(鳞状细胞癌、梭形细胞癌和涎腺肿瘤)、肉芽肿、结节病、乳头状瘤和淀粉样变性均被排除。
共确定24例患者,年龄从2个月至84岁不等。恶性病变(11例)包括软骨肉瘤(6例)、卡波西肉瘤(2例)、转移性黑色素瘤、滑膜细胞肉瘤和T细胞肿瘤。6例接受了支撑喉镜下手术,但4例需要初次或挽救性全喉切除术。2例接受了辅助治疗。良性病变(13例)包括血管瘤(4例)、颗粒细胞瘤(3例)、肌成纤维细胞瘤(2例)、神经鞘瘤(2例)、软骨瘤和骨化性纤维黏液样肿瘤。9例接受了支撑喉镜下手术,4例采用药物治疗或观察。均无需进行根治性开放切除或全喉切除术。
喉非上皮性肿瘤的治疗方法取决于肿瘤的部位和范围、组织学类型以及辅助治疗的敏感性。良性肿瘤无需进行根治性切除,从而保留喉功能。