University of South Dakota Sanford School of Medicine.
S D Med. 2023 Jun;76(suppl 6):s19-s20.
Laryngeal chondrosarcomas are an extremely rare class of tumor accounting for only 1% of all laryngeal tumors. The cricoid cartilage is the most common cartilage from which laryngeal chondrosarcomas arise however, it is also the most difficult to treat as the cricoid cartilage is vital for structural support in the larynx. In this study, we describe a case of low-grade laryngeal chondrosarcoma that arose in the cricoid cartilage and was treated with laser resection while retaining full function of the larynx.
The patient was a 61-year-old man who presented with a two-year history of hoarseness and recent intermittent swelling of the neck. After initial exam, a CT scan was ordered and showed a 2.7 cm calcified mass in the patient's larynx. Subsequent bronchoscopy found a dome shaped mass of the cricoid cartilage resulting in a 50% airway reduction. A biopsy was taken and diagnosed as low-grade laryngeal chondrosarcoma. Laser resection by way of anterior commissure laryngoscope was determined to be the best treatment course as it would result in the best chance of functional retention. Using this method, the mass was debulked to the point that a ridged Hopkins rod telescope could be passed through the airway although complete resection was not possible. The patient reported significant improvement to his symptoms. This improvement was sustained 5 months post- operatively and the mass showed no signs of progression to that point.
This case presented a rare tumor in a location where functional retention is difficult. Through laser resection, the tumor was removed with complete functional retention and abolition of symptoms. Though recurrence is an ever-present possibility, the low grade of the tumor combined with the slow progression of symptoms pre-operatively suggests this surgery could provide extended relief of symptoms.
喉软骨肉瘤是一种极为罕见的肿瘤类别,仅占所有喉肿瘤的 1%。环状软骨是最常见的喉软骨肉瘤起源软骨,但由于环状软骨对喉的结构支撑至关重要,因此也是最难治疗的。在本研究中,我们描述了一例起源于环状软骨的低级别喉软骨肉瘤病例,该病例通过激光切除治疗,同时保留了喉的全部功能。
患者为 61 岁男性,因嗓音嘶哑两年,近期间歇性颈部肿胀就诊。初步检查后,行 CT 扫描显示患者喉部有 2.7 厘米钙化肿块。随后的支气管镜检查发现环状软骨有穹顶状肿块,导致气道狭窄 50%。进行活检,诊断为低级别喉软骨肉瘤。通过前联合喉镜进行激光切除被确定为最佳治疗方案,因为它可以最大程度地保留功能。通过这种方法,肿块被切除到可以通过气道的 Hopkins 杆望远镜,但无法完全切除。患者报告症状显著改善。术后 5 个月,症状持续改善,肿块无进展迹象。
本例呈现出一种罕见的位于难以保留功能部位的肿瘤。通过激光切除,在保留全部功能和消除症状的同时切除了肿瘤。尽管复发的可能性始终存在,但肿瘤的低级别和术前症状的缓慢进展表明,这种手术可以提供更长时间的症状缓解。