Ganguly Arup, Garza Rodolfo, Jain Vinayak, Narmala Shravan
Internal Medicine, Doctors Hospital at Renaissance/University of Texas Rio Grande Valley, Edinburg, USA.
Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA.
Cureus. 2023 May 21;15(5):e39307. doi: 10.7759/cureus.39307. eCollection 2023 May.
The most common malignant laryngeal tumors are squamous cell carcinomas (SCCs), and other types such as sarcomas are rare. Osteosarcomas of the larynx are extremely rare within the subset of sarcomas, with very few cases reported in the literature. This cancer has a predilection for elderly males, in the sixth to eighth decades of life. Associated symptoms include hoarseness, stridor, and dyspnea. It is known to spread early and has a high rate of recurrence. We present the case of a 73-year-old male, a former smoker, who presented to the clinic with severe dyspnea and progressive hoarseness and was found to have a large exophytic mass arising from the epiglottis. A biopsy of the mass showed a poorly differentiated cancer with osteoid and new bone formation. He then underwent surgical removal of the mass, followed by radiation, and achieved clinical remission. However, a surveillance positron emission tomography (PET) scan 14 months later showed a hypermetabolic lesion in the left lung. Biopsy revealed metastatic osteosarcoma, and unfortunately, this cancer also spread to the brain. In this report, we will focus on the histological features of this rare malignancy and treatment options.
最常见的喉部恶性肿瘤是鳞状细胞癌(SCC),而其他类型如肉瘤则较为罕见。喉骨肉瘤在肉瘤亚型中极为罕见,文献报道的病例很少。这种癌症好发于60至80岁的老年男性。相关症状包括声音嘶哑、喘鸣和呼吸困难。已知其早期会发生转移,复发率很高。我们报告一例73岁男性病例,该患者曾吸烟,因严重呼吸困难和进行性声音嘶哑就诊于诊所,检查发现会厌有一个巨大的外生性肿物。肿物活检显示为低分化癌,伴有骨样组织和新骨形成。随后他接受了肿物手术切除,接着进行放疗,并实现了临床缓解。然而,14个月后的监测正电子发射断层扫描(PET)显示左肺有一个高代谢病灶。活检显示为转移性骨肉瘤,不幸的是,这种癌症还转移到了脑部。在本报告中,我们将重点关注这种罕见恶性肿瘤的组织学特征和治疗选择。